Health care needs in end-stage COPD: A structured literature review

Objective: To give an overview of relevant literature regarding health care needs in end-stage COPD and to identify specific areas where knowledge about needs is still lacking. Methods: We conducted a structured literature review. We used Bradshaw's classification system. Results: Seventy-seven publications were found. Ten publications were included in the review. The results reported cover a wide range of subjects, all regarded as health care needs. Most reported on 'felt need', i.e. needs that are mentioned by patients themselves. Results on 'normative need' (based on expert judgement) were lacking. Conclusion: The literature about the health care needs of patients in the end-stage of COPD is sparse, and there is no commonly accepted definition of health care needs. Looking at the increasing demand for end of life care for COPD patients, there is a clear need for further research on this subject. Practice implications: We especially need to focus on agreement between experts and professionals so that guidelines can be developed. To attend to the unfulfilled needs of end-stage COPD patients, the delivery of health care should be re-examined carefully. (C) 2007 Elsevier Ireland Ltd. All rights reserved.