The Authors: Kevin Patel, MB BChir MA Hons (Cantab.), is Acting Instructor at the Division of Pulmonary and Critical Care Medicine, University of Washington Medical Center, Seattle, USA. Daisy J.A. Janssen, MD, is based at the Centre for Integrated Rehabilitation of Organ Failure, Horn, and Maastricht University, Maastricht, the Netherlands. J. Randall Curtis, MD MPH, is Professor of Medicine at the University of Washington and Section Chief of Pulmonary and Critical Care Medicine at Harborview Medical Center, Seattle, USA.
Advance care planning in COPD
Version of Record online: 21 DEC 2011
© 2011 The Authors. Respirology © 2011 Asian Pacific Society of Respirology
Volume 17, Issue 1, pages 72–78, January 2012
How to Cite
PATEL, K., JANSSEN, D. J.A. and CURTIS, J. R. (2012), Advance care planning in COPD. Respirology, 17: 72–78. doi: 10.1111/j.1440-1843.2011.02087.x
- Issue online: 21 DEC 2011
- Version of Record online: 21 DEC 2011
- Accepted manuscript online: 18 OCT 2011 09:21AM EST
- Received 28 June 2011; invited to revise 2 August 2011, 23 September 2011; revised 21 September 2011, 23 September 2011; accepted 24 September 2011 (Associate Editor: D Robin Taylor).
- advance care planning;
- chronic obstructive;
- palliative care;
- pulmonary disease
The review aims to discuss current concepts in advance care planning (ACP) for patients with COPD, and to provide a narrative review of recent trends in ACP and end-of-life care for patients with COPD. ACP, which involves patient–clinician communication about end-of-life care, can improve outcomes for patients and their families, and may be especially relevant for patients with COPD. Effective patient–clinician communication is needed to inform and prepare patients about their diagnosis, treatment, prognosis and what dying might be like. It is important for clinicians to understand patients' values and preferences for life-sustaining treatments as well for their site of terminal care. Unfortunately, discussions about ACP and end-of-life care in current practice are scarce, and their quality is often poor. ACP can improve outcomes for patients and their relatives. The challenge remains in the practical implementation of ACP in the clinical setting, especially for patients with COPD. ACP should be implemented alongside curative-restorative care for patients with advanced COPD. The disease course of COPD is such that there will rarely be a clear transition point predicting the timing of the need for initiation of end-of-life care. Future studies should focus on interventions that facilitate concurrent ACP and prepare patients for making in-the-moment decisions, with the goal of improving the quality of end-of-life care.