Consistency of medical record reporting of a set of indicators for proactive palliative care in patients with chronic obstructive pulmonary disease: A pilot study. (February 2017)

• Record Type: Journal Article
• Authors: Duenk, Ria G; Verhagen, Stans C; Janssen, Mireille AE; Dekhuijzen, Richard PNR; Vissers, Kris CP; Engels, Yvonne; Heijdra, Yvonne
• Is Part Of: Chronic respiratory disease. Volume 14:Number 1(2017)
• Page Start: 63
• Page End: 71
• Publication Date: 2017-02
• Subjects: Chronic obstructive pulmonary disease -- exacerbation -- indicators -- proactive palliative care -- prognosis; Respiratory organs -- Diseases -- Periodicals; 616.2005
• DOI: 10.1177/1479972316661922
• Languages: English
• ISSNs: 1479-9723

Abstract

To identify patients hospitalized for an acute exacerbation of chronic obstructive pulmonary disease (COPD) who have a poor prognosis and might benefit from proactive palliative care, a set of indicators had been developed from the literature. A patient is considered eligible for proactive palliative care when meeting ≥2 criteria of the proposed set of 11 indicators. In order to develop a doctor-friendly and patient-convenient tool, our primary objective was to examine whether these indicators are documented consistently in the medical records. Besides, percentage of patients with a poor prognosis and prognostic value were explored. We conducted a retrospective medical record review of 33 patients. Five indicators; non-invasive ventilation (NIV), comorbidity, body mass index (BMI), previous admissions for acute exacerbation COPD and age were always documented. Three indicators; hypoxaemia and/or hypercapnia, professional home care and actual forced expiratory volume1% (FEV1%) were documented in more than half of the records, whereas the clinical COPD questionnaire (CCQ), medical research council dyspnoea (MRC dyspnoea) and the surprise question were never registered. Besides, 78.8% of the patients met ≥2 criteria and there was a significant association between meeting ≥2 criteria and mortality within 1 year (one-sided Fisher's exact test, p = 0.04). The set of indicators for proactive palliative care in patients with COPD appeared to be user-friendly and feasible.