Journal
RESPIRATORY MEDICINE
Volume 107, Issue 11, Pages 1731-1739Publisher
W B SAUNDERS CO LTD
DOI: 10.1016/j.rmed.2013.06.003
Keywords
COPD; Dementia; Heart failure; Neoplasms; Palliative care; Referral
Funding
- Flemish government agency for Innovation by Science and Technology (Agentschap voor Innovatie door Wetenschap en Technologie) (SBO IWT) [100036]
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Aim: To describe how patients with COPD, heart failure, dementia and cancer differ in frequency and timing of referral to palliative care services. Methods: We performed a population-based study with the Sentinel Network of General Practitioners in Belgium. Of 2405 registered deaths respectively 5%, 4% and 28% were identified as from COPD, heart failure or cancer and 14% were diagnosed with severe dementia. GPs reported use and timing of palliative care services and treatment goals in the final three months of life. Results: Patients with COPD (20%) were less likely than those with heart failure (34%), severe dementia (37%) or cancer (60%) to be referred to palliative care services (p < 0.001). The median days between referral and death was respectively 10, 12, 14 and 20. Patients with COPD who were not referred more often received treatment with a curative or life-prolonging goal and less often with a palliative or comfort goal than did the other patients who were not referred. Conclusion: Patients with COPD are underserved in terms of palliative care compared to those with other chronic life-limiting diseases. Awareness of palliative care as an option for patients with COPD needs to increase in palliative care services, physicians and the general public. (C) 2013 Elsevier Ltd. All rights reserved.
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