Palliative and Supportive Care in Chronic Obstructive Pulmonary Disease: Research Priorities to Decrease Suffering

Chronic obstructive pulmonary disease (COPD) affects 80 million people worldwide, is the fourth most prevalent cause of death globally and accounts for 3.5% of total years lost due to disability. Despite the similarities with malignant disease, many individuals suffer unnecessarily and continue to have limited access to palliative and endof- life care. Changing this will require a shift in focus and approach as well as support for clinical decision making. Lack of communication regarding care plans and prognosis and coordination across care settings has been identified as barriers to end-of-life care. Research specifically should focus on improving the use of comprehensive and collaborative approaches to end-stage COPD care such as those illustrated in the Chronic Care Model which has demonstrated improved outcomes for chronic conditions. Revision of funding models and workforce organisation, aided by clinical pathways may improve end of life care for COPD.