Palliative Care in COPD

Abstract

People who live with chronic obstructive pulmonary disease (COPD), the fourth leading cause of death in the United States, have chronic and progressively debilitating dyspnea and systemic symptoms that reduce quality of life and result in high acute care utilization near the end of life. Despite recommendations to integrate specialist palliative care in COPD and the proven benefits of its early integration in the care of patients with advanced cancer, specialist palliative care is exceedingly rare in COPD and is not typically considered by pulmonary clinicians until a person is at the very end of life. Palliative care beyond its role at the very end of life has much to offer patients with COPD and their families earlier in the disease trajectory. This chapter calls for early integration of palliative care into routine practice for COPD. We explore broad care needs experienced by patients with COPD and their families, define barriers to proactive palliative care referral in COPD, describe feasible inter-professional models for palliative care integration in COPD, and propose an innovative strategy for early palliative care integration into routine COPD practice through the fusion of palliative care into the field of pulmonary medicine, i.e., a “pallipulm” approach.