COPD and Palliative Care
Aristotle University of Thessaloniki
‘’Chronic Obstructive Pulmonary Disease (COPD) is a common, preventable and treatable disease that is characterized by persistent respiratory symptoms and airflow limitation that is due to airway and/or alveolar abnormalities usually caused by significant exposure to noxious particles or gases. The most common respiratory symptoms include dyspnoea, cough and/or sputum production. These symptoms may be under-reported by patients ’’.
Smoking and environmental factors, like pollution, are the main risk factors for COPD. Usually, COPD is the third most common cause of death worldwide associated with severe comorbidities which increase the morbidity and mortality of the patients. There are exacerbation periods with acute worsening of respiratory issues. Due to the chronic breathlessness, many patients experience reduced quality of life and reduced function that affects daily living activities making it inevitable to cope without additional support from informal and/or paid caregivers for significant periods of their life. Increasing social isolation and reducing quality of life create significant psychological issues to these patients .
Global COPD guidelines  recommend the early inclusion of patients to palliative care. Palliative care can help these patients through therapy and provide them with emotional, psychological, and spiritual support improving their quality of life. Family and caregivers can also benefit from palliative services to better care for the patients while maintaining patients’ and their own wellbeing . Clinicians could use palliative care as an extra tool to support their patients and guide them after their prognosis to the appropriate therapy and treatment choices according to their needs and desires. Palliative care, still under development in Europe, consists a major challenge for patients with COPD as they remain out of this frame in healthcare systems. COPD patients have the right to optimal palliative support, and we should stand by their side until they have it.
InAdvance project focuses on the early inclusion of patients with complex chronic conditions, such as COPD, in palliative care services to benefit from additional supportive care in addition to the normal therapies such as bronchodilators, oxygen therapy or pulmonary rehabilitation programs. InAdvance clinical trials will include patients with COPD, especially under the Portuguese, Greek and UK clinical sites.
 GOLD (Global Initiative for Chronic Obstructive Lung Disease) 2017. (2017). Pneumologie, 71(01), 9-14. doi: 10.1055/s-0042-121903
 Smallwood, N., Currow, D., Booth, S., Spathis, A., Irving, L., & Philip, J. (2018). Attitudes to specialist palliative care and advance care planning in people with COPD: a multi-national survey of palliative and respiratory medicine specialists. BMC Palliative Care, 17(1). doi: 10.1186/s12904-018-0371-8
 Halpin, D. (2018). Palliative care for people with COPD: effective but underused. European Respiratory Journal, 51(2), 1702645. doi: 10.1183/13993003.02645-2017