Tuesday, 26 August 2008

End-of-life care for COPD patients

End-of-life care for COPD patients.
Primary care respiratory journal : journal of the General Practice Airways Group, Mar 2008, vol. 17, no. 1
p. 46-50
Patients with chronic obstructive pulmonary disease (COPD) receive poor end-of-life (EoL) care, in part because their disease course is not predictable. If the family physician would not be surprised at the patient's death within a year, then EoL issues should be raised for discussion. Embarking on such a discussion has the potential to enhance the patient's quality of life and EoL care, thereby avoiding unnecessary treatments or interventions. An Advance Health Care Directive can be useful. Appropriately-used systemic (not nebulised) opioids are safe and effective for managing dyspnoea. The family physician is in an excellent position to provide comprehensive EoL care for COPD patients.

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