References

British Lung Foundation. 2017. https://www.blf.org.uk/policy/out-in-the-cold

British Lung Foundation. 2019. https://tinyurl.com/ugdvgu6

Fletcher CM Standardized questionnaire on respiratory symptoms: a statement prepared and approved by the MRC Committee on the Aetiology of Chronic Bronchitis (MRC breathlessness score). BMJ.. 1960; 2 https://tinyurl.com/wk8jdsm

Gomes B, Higginson I, Calanzani N Preferences for place of death if faced with advanced cancer: a population survey in England, Flanders, Germany, Italy, the Netherlands, Portugal and Spain. Ann Oncol. 2012; 23:(8) https://doi.org/10.1093/annonc/mdr602

Hearn J, Higginson I Development and validation of a core outcome measure for palliative care: the palliative care outcome scale. Palliative Care Core Audit Project Advisory Group. BMJ Qual Saf.. 1999; 8

Higginson I, Reilly C, Bajwah S, Maddocks M, Costantini M, Gao W Which patients with advanced respiratory disease die in hospital? A 14-year population-based study of trends and associated factors.. BMC Medicine.. 2017; 15 https://doi.org/10.1186/s12916-016-0776-2

Lung Clinical Expert Group. 2017. https://tinyurl.com/r8bvras

Palliative Care Outcome Scale. 2014. https://pos-pal.org/maix/ipos_in_english.php

Public Health England. 2015. https://tinyurl.com/yyby58qd

Salciccioli J, Marshall D, Shalhoub J, Maruthappu M, De Carlo G, Chung KF Respiratory disease mortality in the United Kingdom compared with EU15+ countries in 1985-2015: observational study. BMJ.. 2018; 363 https://doi.org/10.1136/bmj.k4680

Gold Standards Framework Team. 2016. https://tinyurl.com/wnkawz7

Palliative care for chronic respiratory disease: integrated care in outpatient settings

02 March 2020
Volume 25 · Issue 3

Abstract

Chronic respiratory diseases are progressive and often life-limiting illnesses. Patients experience debilitating and troubling symptoms that impact on their quality of life. Despite this, there is under-recognition of patients who may be entering the final year of their life and require palliative care services. The Royal Wolverhampton NHS Trust in partnership with Compton Care has established chronic respiratory disease multidisciplinary team meetings and a combined respiratory and palliative care outpatient clinic to address these issues. This article presents the impact of this service, now in to its fourth year, of delivering palliative care services to patients with chronic respiratory disease.

Respiratory disease affects one in five people in the UK and is the third most common cause of death (Public Health England, 2015). Hospital admissions for respiratory-related diseases are rising at three times the rate of admissions for other conditions (British Lung Foundation, 2017). Some 56.4% of respiratory-related deaths in 2012 were the result of lung cancer or an acute pneumonic illness, while 32.1% of deaths resulted from chronic respiratory diseases, such as chronic obstructive pulmonary disease (COPD) (26.1%), idiopathic pulmonary fibrosis (IPF) (4.6%) and bronchiectasis (1.4%) (British Lung Foundation, 2019). Furthermore, the UK remains an outlier for respiratory-related age-standardised mortality rates compared with other European countries (Salciccioli et al, 2018).

In Wolverhampton in 2015, it was recognised that patients fulfilling COPD Gold Standard Framework (GSF) criteria were either not registered on the GP palliative care registers or had minimal interaction with or access to palliative care services. Thus, patients reaching the last stage of disease were not identified, and opportunities to provide preferential or optimal end-of-life care were lost. In response, chronic respiratory multidisciplinary team (CR-MDT) meetings and a combined respiratory-palliative clinic (CRPC) were established between Compton Care (a community palliative care service including community and hospice care) and the Royal Wolverhampton NHS Trust. This article describes the evolution of these services and their impact on patient journeys.

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