Elsevier

Respiratory Medicine

Volume 107, Issue 11, November 2013, Pages 1731-1739
Respiratory Medicine

Referral to palliative care in COPD and other chronic diseases: A population-based study

https://doi.org/10.1016/j.rmed.2013.06.003Get rights and content
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Summary

Aim

To describe how patients with COPD, heart failure, dementia and cancer differ in frequency and timing of referral to palliative care services.

Methods

We performed a population-based study with the Sentinel Network of General Practitioners in Belgium. Of 2405 registered deaths respectively 5%, 4% and 28% were identified as from COPD, heart failure or cancer and 14% were diagnosed with severe dementia. GPs reported use and timing of palliative care services and treatment goals in the final three months of life.

Results

Patients with COPD (20%) were less likely than those with heart failure (34%), severe dementia (37%) or cancer (60%) to be referred to palliative care services (p < 0.001). The median days between referral and death was respectively 10, 12, 14 and 20. Patients with COPD who were not referred more often received treatment with a curative or life-prolonging goal and less often with a palliative or comfort goal than did the other patients who were not referred.

Conclusion

Patients with COPD are underserved in terms of palliative care compared to those with other chronic life-limiting diseases. Awareness of palliative care as an option for patients with COPD needs to increase in palliative care services, physicians and the general public.

Keywords

COPD
Dementia
Heart failure
Neoplasms
Palliative care
Referral

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