Palliative Management and End-of-Life Care in Nonmalignant Advanced Lung Disease. Issue 5 (September 2017)

• Record Type: Journal Article
• Authors: Khateeb, Dina M.; West, Frances Mae
• Is Part Of: Clinical pulmonary medicine. Volume 24:Issue 5(2017)
• Publication Date: 2017-09
• Subjects: palliative care -- hospice -- end-of-life -- advanced lung disease -- dyspnea; Lungs -- Diseases -- Periodicals; 616.24005
• DOI: 10.1097/CPM.0000000000000229
• Languages: English
• ISSNs: 1068-0640

Abstract

Abstract : Advanced lung disease (ALD) is comprised of nonmalignant, life-limiting respiratory diseases such as chronic obstructive pulmonary disease, idiopathic pulmonary fibrosis, cystic fibrosis, and pulmonary arterial hypertension, sharing common symptoms and reduced quality of life (QOL) in their advanced stages. As the US' population is aging and disease-specific therapies are improving, it is expected that more patients will be diagnosed with ALD and live longer, increasing disability, morbidity, and medical costs because of health care utilization at the end-of-life (EOL). Palliative care provides interdisciplinary care to patients with life-limiting disease throughout the continuum of their illness as a complement to disease-modifying and curative therapies with the purpose of improving QOL. Important components of palliative care include symptom management, advance care planning, and EOL care. The integration of palliative care in disease management has been shown to decrease symptom burden, improve QOL, and reduce medical costs at the EOL, highlighting a significant need in the ALD population. However, when comparing patients with lung cancer to those with ALD, there is a clear disparity in the use of palliative services in ALD patients. Some of the barriers to providing palliative services in ALD are ambiguous disease trajectories, and poor communication between physicians and their patients. All health care providers caring for patients with ALD, especially pulmonologists, should be confident integrating early palliative care measures in this patient population. This article aims to discuss the major components and barriers involved in the palliative management and EOL care in ALD.