Study Investigates the Reliability of Palliative Care for COPD Patients

A study recently published by the International Journal of Chronic Obstructive Pulmonary Disease (COPD), analyzes current recommendations for palliative care (PC) for chronic obstructive pulmonary disease (COPD) patients to determine their level of reliability during an expected 1-year mortality.

PC is typically used for patients with neoplastic diseases and may be used with other therapies to improve symptoms and the overall quality of life. PC has proven to be effective in COPD, but it is more complicated in utilization.

"One of the main barriers for initiating PC in COPD is the unpredictability of vital prognosis in an individual patient," the authors wrote. "Many COPD patients present a gradual deterioration, others stability for years, while a subgroup suffers acute COPD exacerbations."

The study involved 3 main phases to determine the reliability of PC for COPD patients:

1. Identify variables proposed in the literature as main criteria for considering initiating PC in COPD patients, based on a foreseeable poor prognosis in the short or medium term (≤1-year survival)
2. Ascertain the relationship between these proposed variables and 1-year mortality, retrieving the data from the original studies
3. Validate the utility of the proposed variables in a cohort of patients hospitalized for COPD exacerbation

Of the 697 patients hospitalized for COPD exacerbation included in the study, 93% were males and had a 1-mortality rate of 17.5%. However, of those whom met the criteria for PC, there was not a statistical significance in mortality differences.

“The main conclusion of our study is that none of the suggested criteria for initiating PC based on an expected poor vital prognosis in COPD patients in the short or medium term offers sufficient reliability, and perhaps, they should be avoided as exclusive criteria for considering PC or at least critically evaluated,” the authors concluded.

Despite the lack of statistical differences, the researchers suggested that the decision to begin PC should be paired with restorative care. Furthermore, PC is often associated with only being necessary for terminal care, but the study recommended considering its applicability when used with other therapies.