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Can we discuss end of life care with patients with COPD?

11 February 2015

I’m Nuno Tavares, a staff nurse at Queen Alexandra Hospital and I’m also a PhD student carrying out research for NIHR CLAHRC Wessex and Portsmouth Hospitals NHS Trust. My research is about improving end of life care for patients with COPD.

Chronic Obstructive Pulmonary Disease (COPD) is characterised as a slowly progressive disease, with advanced disease frequently resulting in increased exacerbations and hospital admissions, the need for life-saving interventions, and poor quality of life. Moreover, COPD is often associated with breathlessness, anxiety, depression, lack of energy, anorexia and restricted mobility.

COPD is the leading cause of respiratory related deaths and is the fourth overall leading cause of death in the world. In the UK, an estimate of 3 million people have COPD, with 2 million of them remaining undiagnosed, in total COPD is responsible for around 30,000 deaths every year.

The quality and the proportion of patients with COPD who receive palliative care compare poorly to the care received by patients with cancer. Several studies show that most patients do not discuss end of life issues with their physicians, even though they may wish to. Figures show that around 77% of all patients never discussed end of life care with their healthcare professional, yet about 62% report the desire to have such conversations. The vast majority of patients believe that their physicians do not understand their preferences for end-of-life care.

My research will specifically look at end of life care discussions between healthcare professionals, such as doctors and nurses, and patients with COPD. The development of this research will improve standards of end of life care for people with COPD and their relatives, enable healthcare professionals to start conversations in an early stage, reduce hospital admissions, reduce futile treatments and reduce overall costs.

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