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MALADIE RESPIRATOIRE

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Advance care planning in chronically ill persons diagnosed with heart failure or chronic obstructive pulmonary disease - an integrative review

WILLIAMS, Molly T. ; KOZACHIK, Sharon L. ; KARLEKAR, Mohana ; WRIGHT, Rebecca
The American journal of hospice and palliative care, 13/03/2020, Pagination inconnue

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Health care costs at end-of-life for patients with idiopathic pulmonary fibrosis - evaluation of a pilot multidisciplinary clinic

KALLURI, Meena ; LU-SONG, Jenny ; YOUNUS, Sarah ; NABIPOOR, Majid ; RICHMAN-EISENSTAT, Janice ; OHINMAA, Arto ; BAKAL, Jeffrey A.
Annals of the American Thoracic Society, 20/03/2020, Pagination inconnue

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Thème : Médecine.

COUT SANTE ; FIN VIE ; MALADIE RESPIRATOIRE ; DEMARCHE PALLIATIVE ; TRAJECTOIRE MALADIE

RATIONALE: Even though Idiopathic pulmonary fibrosis (IPF) is a disease with high morbidity and mortality and no cure, palliative care is rarely implemented, leading to high symptom burden and unmet care needs. In 2012 we implemented a Multidisciplinary Collaborative (MDC) care model linking clinic and community multidisciplinary teams to provide an early-integrated palliative approach, focusing on early symptom management and advanced care planning (ACP).
OBJECTIVES: This study evaluates the differences in resource utilization and associated costs of end-of-life care between early-integrated palliative and conventionally treated IPF patients.
METHODS: Using administrative health data, we identified all patients in Alberta who presented to hospital with an IPF diagnosis between Jan 1, 2012 and Dec 31, 2018 and died within this timeframe. We compared 3 groups of patients: those who received (1) MDC care (our clinic patients), (2) specialist care (SC; respirologist), and (3) non-specialist care (NSC; no contact with a respiratory clinic). The primary outcomes were health care resource utilization and costs in the year before death.
RESULTS: Of 2,768 patients across three groups, MDC patients were over 3 times more likely to have received anti-fibrotic therapies over SC patients (OR=3.0; 95%CI 1.8-5.2), almost twice as likely to receive pulmonary rehab (OR=1.9; 95%CI 1.1-3.4) and 36% more likely to receive opiates (OR=1.4; 95%CI 0.8-2.3) in the last year of life. The median total health care costs in the last 3 months of life were approximately $7,700 CDN lower for MDC patients compared to those receiving specialist care, driven primarily by fewer hospitalizations and ED visits. MDC patients were also less likely to die in hospital (44.9% MDC vs 64.9% SC vs 66.8% NSC, p<0.001) and had the highest rates of no hospitalization in the last year of life.
CONCLUSIONS: An integrated palliative approach in IPF is associated with improvements in the quality of end-of-life care and reduction in costs. Transformation of care models is required to deliver a palliative approach in IPF. Multidisciplinary collaborative teams within such models can address the high burden of unmet needs for symptom management, advance care planning (ACP) and community support in this complex population.

Origine : PubMed

Earlier palliative home care is associated with patient-centered medical resource utilisation and lower costs in the last 30 days before death in COPD - a population-level decedent cohort study

SCHEERENS, Charlotte ; FAES, Kristof ; PYPE, Peter ; BEERNAERT, Kim ; JOOS, Guy ; DEROM, Eric ; COHEN, Joachim ; DELIENS, Luc ; CHAMBAERE, Kenneth
The European respiratory journal, 27/02/2020, Pagination inconnue

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

HUNTLEY, Christopher ; HAKKAK, Frances ; WARD, Helen
British journal of community nursing, 02/03/2020, vol.25, n°3, p. 132-138

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Palliative care for non-cancer conditions in primary care - a time trend analysis in the UK (2009-2014)

GADOUD, Amy ; KANE, Eleanor ; OLIVER, Steven Edward ; JOHNSON, Miriam J. ; MACLEOD, Una ; ALLGAR, Victoria
BMJ supportive and palliative care, 13/01/2020, Pagination inconnue

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The impact of palliative care on quality of life, anxiety, and depression in idiopathic pulmonary fibrosis - a randomized controlled pilot study

JANSSEN, Katherine ; ROSIELLE, Drew ; WANG, Qi ; KIM, Hyun Joo
Respiratory research, 03/01/2020, vol.21, n°1, p. 1-9

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End-of-life spending and healthcare utilization among older adults with chronic obstructive pulmonary disease

IYER, Anand S. ; GOODRICH, Christine A. ; DRANSFIELD, Mark T. ; ALAM, Shama S. ; BROWN, Cynthia J. ; LANDEFELD, C. Seth ; BAKITAS, Marie A. ; BROWN, Jeremiah R.
The American journal of medicine, 26/12/2019, Pagination inconnue

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Opioid utility for dyspnea in chronic obstructive pulmonary disease - a complicated and controversial story

VOZORIS, Nicholas T.
Annals of palliative medicine, 15/12/2019, Pagination inconnue

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Advance care planning for individuals with chronic obstructive pulmonary disease - a scoping review of the literature

MEEHAN, Elaine ; FOLEY, Tony ; KELLY, Ms Claire ; BURGESS KELLEHER, Art ; SWEENEY, Catherine ; HALLY, Ruth M. ; DETERING, Karen ; CORNALLY, Nicola
JOURNAL OF PAIN AND SYMPTOM MANAGEMENT, 11/12/2019, Pagination inconnue

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Advance care planning in COPD - guidance development for healthcare professionals

MEEHAN, Elaine ; SWEENEY, Catherine ; FOLEY, Tony ; LEHANE, Elaine ; BURGESS KELLEHER, Art ; HALLY, Ruth M. ; SHANAGHER, Deirdre ; KORN, Bettina ; RABBITTE, Mary ; DETERING, Karen Margaret ; CORNALLY, Nicola
BMJ supportive and palliative care, 04/11/2019, Pagination inconnue

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A qualitative study of pulmonary and palliative care clinician perspectives on early palliative care in chronic obstructive pulmonary disease

IYER, Anand S. ; DIONNE-ODOM, James Nicholas ; KHATEEB, Dina M. ; O'HARE, Lanier ; TUCKER, Rodney O. ; BROWN, Cynthia J. ; DRANSFIELD, Mark T. ; BAKITAS, Marie A.
JOURNAL OF PALLIATIVE MEDICINE, 29/10/2019, Pagination inconnue

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Early-integrated palliative home care and standard care for end-stage COPD (EPIC) - a phase II pilot RCT testing feasibility, acceptability and effectiveness

SCHEERENS, Charlotte ; PYPE, Peter ; VAN CAUWENBERG, Jelle ; VANBUTSELE, Gaëlle ; EECLOO, Kim ; DEROM, Eric ; VAN BELLE, Simon ; JOOS, Guy ; DELIENS, Luc ; CHAMBAERE, Kenneth
JOURNAL OF PAIN AND SYMPTOM MANAGEMENT, 09/10/2019, Pagination inconnue

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Thème : Médecine.

HOSPITALISATION DOMICILE SOINS PALLIATIFS ; MALADIE CHRONIQUE ; MALADIE RESPIRATOIRE ; EFFICACITE ; EVALUATION

BACKGROUND: While early-integrated palliative home care (PHC) is believed to be beneficial for COPD patients, trials testing this hypothesis are rare and show inconclusive results.
AIM: To test feasibility, acceptability and preliminary effectiveness of early-integrated PHC for end-stage COPD.
METHOD: Testing a six-month early-integrated PHC pilot RCT given by PHC nurses for end-stage COPD with five components: (1) pre-inclusion COPD support training for PHC nurses; (2) monthly PHC visits; (3) leaflets on coping mechanisms; (4) a protocol on symptom management and support, a care and action plan; (5) integration of PHC and usual care through reporting and communication mechanisms. Patient-reported outcomes were assessed six-weekly. Participants and healthcare professionals involved were interviewed.
RESULTS: Of 70 eligible patients, 39 (56%) participated (20:19 intervention-control) and 64% completed the trial. A patient received on average 3.4 PHC visits, mainly for disease insight, symptom management and care planning. Nurses distributed all reports but hardly connected with health professionals except general practitioners (GPs); 8/10 interviewed patients referred to the psychosocial support, breathing exercises and care decisions as helpful. Some GPs criticised PHC being given too early but pulmonologists and PHC nurses did not. Effectiveness analysis showed no overall intervention effect for the outcomes, but between baseline and week 24 fewer hospitalisations in the control group (p=0.03) and a trend of higher perceived quality of care in the intervention group (p=0.06) was found. A clinically relevant difference was observed at week 24 for health-related quality of life in favour of the control group.
CONCLUSION: Our intervention on early-integrated PHC for end-stage COPD is feasible and accepted but did not yield the anticipated preliminary effectiveness. Before moving to a Phase III-trial, enhanced coordination of care, more GP involvement, more intensive training for PHC nurses in COPD support and revision of the trial design, e.g. of targeted outcomes in line with individual patient goals and care preferences should be improved.

Origine : PubMed

Treatment decisions in end-stage COPD: who decides how? - a cross-sectional survey of different medical specialties

GABLER, Martin ; OHRENBERGER, Gerald ; FUNK, Georg-Christian
ERJ open research, 07/2019, vol.5, n°3, p. 1-10

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End-of-life care in individuals with respiratory diseases - a population study comparing the dying experience between those with chronic obstructive pulmonary disease and lung cancer

KENDZERSKA, Tetyana ; NICKERSON, Jason W. ; HSU, Amy T. ; GERSHON, Andrea S. ; TALARICO, Robert ; MULPURU, Sunita ; PAKHALE, Smita ; TANUSEPUTRO, Peter
International journal of chronic obstructive pulmonary disease, 2019, vol.14, p. 1691-1701

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Early do-not-resuscitate directives decrease invasive procedures and health care expenses during the final hospitalization of life of copd patients

FU, Pin-Kuei ; YANG, Ming-Chin ; WANG, Chen-Yu ; LIN, Shin-Pin ; KUO, Chen-Tsung ; HSU, Chiann-Yi ; TUNG, Yu-Chi
JOURNAL OF PAIN AND SYMPTOM MANAGEMENT, 09/08/2019, Pagination inconnue

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Integrating palliative home care early into standard care of end-stage COPD

SCHEERENS, Charlotte
ASP nv , 2019 , 297 p.

Longer duration of palliative care in patients with COPD is associated with death outside the hospital

KRASKOVSKY, Valeri ; SCHNEIDER, Jaclyn ; MADOR, M. Jeffery ; PROVOST, Karin A.
JOURNAL OF PALLIATIVE CARE, 02/07/2019, Pagination inconnue

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Nurse-led integration of palliative care for chronic obstructive pulmonary disease - an integrative literature review

ORA, Linda ; MANNIX, Judy ; MORGAN, Lucy ; WILKES, Lesley
Journal of clinical nursing, 20/07/2019, Pagination inconnue

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Immune checkpoint inhibitor outcomes for patients with non-small-cell lung cancer receiving baseline corticosteroids for palliative versus nonpalliative indications

RICCIUTI, Biagio ; DAHLBERG, Suzanne E. ; ADENI, Anika ; SHOLL, Lynette M. ; NISHINO, Mizuki ; AWAD, Mark M.
Journal of clinical oncology, 17/06/2019, Pagination inconnue

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Thème : Médecine.

ANTI INFLAMMATOIRE STEROIDIEN ; DEMARCHE PALLIATIVE ; MALADIE RESPIRATOIRE ; IMMUNOTHERAPIE ; CANCER RESPIRATOIRE

Purpose: Baseline use of corticosteroids is associated with poor outcomes in patients with non-small-cell lung cancer (NSCLC) treated with programmed cell death-1 axis inhibition. To approach the question of causation versus correlation for this association, we examined outcomes in patients treated with immunotherapy depending on whether corticosteroids were administered for cancer-related palliative reasons or cancer-unrelated indications.
Patients and methods: Clinical outcomes in patients with NSCLC treated with immunotherapy who received >= 10 mg prednisone were compared with outcomes in patients who received 0 to < 10 mg of prednisone.
RESULTS: Of 650 patients, the 93 patients (14.3%) who received >= 10 mg of prednisone at the time of immunotherapy initiation had shorter median progression-free survival (mPFS) and median overall survival (mOS) times than patients who received 0 to < 10 mg of prednisone (mPFS, 2.0 v 3.4 months, respectively; P = .01; mOS, 4.9 v 11.2 months, respectively; P < .001). When analyzed by reason for corticosteroid administration, mPFS and mOS were significantly shorter only among patients who received >= 10 mg prednisone for palliative indications compared with patients who received >= 10 mg prednisone for cancer-unrelated reasons and with patients receiving 0 to < 10 mg of prednisone (mPFS, 1.4 v 4.6 v 3.4 months, respectively; log-rank P < .001 across the three groups; mOS, 2.2 v 10.7 v 11.2 months, respectively; log-rank P < .001 across the three groups). There was no significant difference in mPFS or mOS in patients receiving >= 10 mg of prednisone for cancer-unrelated indications compared with patients receiving 0 to < 10 mg of prednisone.
CONCLUSION: Although patients with NSCLC treated with >= 10 mg of prednisone at the time of immunotherapy initiation have worse outcomes than patients who received 0 to < 10 mg of prednisone, this difference seems to be driven by a poor-prognosis subgroup of patients who receive corticosteroids for palliative indications.

Origine : PubMed

Advancing symptom alleviation with palliative treatment (adapt) trial to improve quality of life - a study protocol for a randomized clinical trial

GRANEY, Bridget A. ; AU, David H. ; BARON, Anna E. ; CHENG, Andrew ; COMBS, Sara A. ; GLORIOSO, Thomas J. ; PADEN, Grady ; PARSONS, Elizabeth C. ; RABIN, Borsika A. ; RITZWOLLER, Debra P. ; STONECIPHER, Jessica-Jean ; TURVEY, Carolyn ; WELSH, Carolyn H. ; BEKELMAN, David B.
Trials, 13/06/2019, vol.20, n°1, p. 1-11

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