open access

Vol 78, No 2 (2010)
REVIEWS
Published online: 2010-03-19
Submitted: 2013-02-22
Get Citation

Integrated care for patients with advanced chronic obstructive pulmonary disease

Ewa Jassem, Dorota Górecka, Piotr Krakowiak, Jerzy Kozielski, J. Marek Słomiński, Małgorzata Krajnik, Andrzej M. Fal
Pneumonol Alergol Pol 2010;78(2):126-132.

open access

Vol 78, No 2 (2010)
REVIEWS
Published online: 2010-03-19
Submitted: 2013-02-22

Abstract

Chronic obstructive pulmonary disease (COPD) is the third cause of mortality and disability (assed by DALY) among patients above 60 year old. Severe and very severe COPD (FEV1 = equal or less than 50% and 30% of expected value, respectively) is estimated at 20% of all COPD patients. Advanced COPD usually leads to physical and mental deterioration, the patients often manage with the problems caused by the disease and other comorbidities poorly. This leads to increased risk of COPD exacerbations and further deterioration of the patient’s status, increased costs of medical care and eventually increased risk of death. Current organization of medical care for those patients does not provide adequate health and social support for them. However, it seems that introducing an integrated approach proposed by World Health Organization, could improve the situation of advanced COPD patients. In Poland, this kind of care has been provided in advanced cancer patients throughout stationary palliative care units and hospices during the last several years. This experience should be helpful in integrating actions of general practitioners and specialized nurses, as well as providing access for the specialists’ consultations according to the individual needs of the patients. It should also allow for broad cooperation with auxiliary staff, such as social workers, medical assistants and volunteers, as well as psychologists and clergymen (especially in the terminal phase of the disease).
Pneumonol. Alergol. Pol. 2010; 78, 2: 126-132

Abstract

Chronic obstructive pulmonary disease (COPD) is the third cause of mortality and disability (assed by DALY) among patients above 60 year old. Severe and very severe COPD (FEV1 = equal or less than 50% and 30% of expected value, respectively) is estimated at 20% of all COPD patients. Advanced COPD usually leads to physical and mental deterioration, the patients often manage with the problems caused by the disease and other comorbidities poorly. This leads to increased risk of COPD exacerbations and further deterioration of the patient’s status, increased costs of medical care and eventually increased risk of death. Current organization of medical care for those patients does not provide adequate health and social support for them. However, it seems that introducing an integrated approach proposed by World Health Organization, could improve the situation of advanced COPD patients. In Poland, this kind of care has been provided in advanced cancer patients throughout stationary palliative care units and hospices during the last several years. This experience should be helpful in integrating actions of general practitioners and specialized nurses, as well as providing access for the specialists’ consultations according to the individual needs of the patients. It should also allow for broad cooperation with auxiliary staff, such as social workers, medical assistants and volunteers, as well as psychologists and clergymen (especially in the terminal phase of the disease).
Pneumonol. Alergol. Pol. 2010; 78, 2: 126-132
Get Citation

Keywords

chronic obstructive pulmonary disease (COPD); integrated treatment; coordinator; palliative care

About this article
Title

Integrated care for patients with advanced chronic obstructive pulmonary disease

Journal

Advances in Respiratory Medicine

Issue

Vol 78, No 2 (2010)

Pages

126-132

Published online

2010-03-19

Bibliographic record

Pneumonol Alergol Pol 2010;78(2):126-132.

Keywords

chronic obstructive pulmonary disease (COPD)
integrated treatment
coordinator
palliative care

Authors

Ewa Jassem
Dorota Górecka
Piotr Krakowiak
Jerzy Kozielski
J. Marek Słomiński
Małgorzata Krajnik
Andrzej M. Fal

References (40)
  1. Marmot M. Health in an unequal world. The Lancet. 2006; 368(9552): 2081–2094.
  2. WHO. World Health Report. 2003.
  3. www.copdgold.com (11.2009).
  4. Pływaczewski R, Maciejewski J, Bednarek M, et al. Prevalence, severity and underdiagnosis of COPD in the primary care setting. Thorax. 2008; 63(5): 402–407.
  5. Nizankowska-Mogilnicka E, Mejza F, Buist AS, et al. Prevalence of COPD and tobacco smoking in Malopolska region--results from the BOLD study in Poland. Pol Arch Med Wewn. 2007; 117(9): 402–410.
  6. Wagner PD. Skeletal muscles in chronic obstructive pulmonary disease: deconditioning, or myopathy? Respirology. 2006; 11(6): 681–686.
  7. Doucet M, Russell AP, Léger B, et al. Muscle atrophy and hypertrophy signaling in patients with chronic obstructive pulmonary disease. Am J Respir Crit Care Med. 2007; 176(3): 261–269.
  8. Koehler F, Doehner W, Hoernig S, et al. Anorexia in chronic obstructive pulmonary disease--association to cachexia and hormonal derangement. Int J Cardiol. 2007; 119(1): 83–89.
  9. Burge S, Wedzicha JA. COPD exacerbations: definitions and classifications. Eur Respir J Suppl. 2003; 41: 46s–53s.
  10. Soler-Cataluña JJ, Martínez-García MA, Román Sánchez P, et al. Severe acute exacerbations and mortality in patients with chronic obstructive pulmonary disease. Thorax. 2005; 60(11): 925–931.
  11. Jahnz-Różyk K. Farmakoekonomika przewlekłej obturacyjnej choroby płuc. Pneumonol Alergol Pol. 2009; 77: 302–307.
  12. Jahnz-Różyk K, Targowski T, From S. Koszty leczenia zaostrzeń przewlekłej obturacyjnej choroby płuc w warunkach ambulatoryjnych i szpitalnych w 2007 roku — wyniki wieloośrodkowego badania polskiego. . Pol. Merkuriusz Lek. 2009; 26: 208–214.
  13. Foster TS, Miller JD, Marton JP, et al. Assessment of the economic burden of COPD in the U.S.: a review and synthesis of the literature. COPD. 2006; 3(4): 211–218.
  14. McNicholas WT. Chronic obstructive pulmonary disease and obstructive sleep apnea: overlaps in pathophysiology, systemic inflammation, and cardiovascular disease. Am J Respir Crit Care Med. 2009; 180(8): 692–700.
  15. Sin DD, Man SF. Why are patients with chronic obstructive pulmonary disease at increased risk of cardiovascular diseases? The potential role of systemic inflammation in chronic obstructive pulmonary disease. Circulation. 2003; 107(11): 1514–1519.
  16. Soriano JB, Visick GT, Muellerova H, et al. Patterns of comorbidities in newly diagnosed COPD and asthma in primary care. Chest. 2005; 128(4): 2099–2107.
  17. Jassem JM, Bobowicz M, Słomiński JM, et al. The incidence of chronic obstructive pulmonary disease in advanced non-small cell lung cancer patients. Adv Palliat Med. 2007; 6: 107–111.
  18. Norwood R. Prevalence and impact of depression in chronic obstructive pulmonary disease patients. Curr Opin Pulm Med. 2006; 12(2): 113–117.
  19. Maurer J, Rebbapragada V, Borson S, et al. Anxiety and depression in COPD. Chest. 2008; 134: 43–56.
  20. Almagro P, Calbo E, Ochoa de Echagüen A, et al. Mortality after hospitalization for COPD. Chest. 2002; 121(5): 1441–1448.
  21. Yohannes AM, Baldwin RC, Connolly MJ. Predictors of 1-year mortality in patients discharged from hospital following acute exacerbation of chronic obstructive pulmonary disease. Age Ageing. 2005; 34(5): 491–496.
  22. Seneff MG, Wagner DP, Wagner RP, et al. Hospital and 1-year survival of patients admitted to intensive care units with acute exacerbation of chronic obstructive pulmonary disease. JAMA. 1995; 274(23): 1852–1857.
  23. Celli BR, Cote CG, Marin JM, et al. The body-mass index, airflow obstruction, dyspnea, and exercise capacity index in chronic obstructive pulmonary disease. N Engl J Med. 2004; 350(10): 1005–1012.
  24. Claessens M, Lynn J, Zhong Z, et al. Dying with Lung Cancer or Chronic Obstructive Pulmonary Disease: Insights from SUPPORT. Journal of the American Geriatrics Society. 2015; 48(S1): S146–S153.
  25. Zvezdin B, Milutinov S, Kojicic M, et al. A postmortem analysis of major causes of early death in patients hospitalized with COPD exacerbation. Chest. 2009; 136(2): 376–380.
  26. Bustamante-Fermosel A, De Miguel-Yanes JM, Duffort-Falcó M, et al. Mortality-related factors after hospitalization for acute exacerbation of chronic obstructive pulmonary disease: the burden of clinical features. Am J Emerg Med. 2007; 25(5): 515–522.
  27. Jarvis S, Ind PW, Shiner RJ. Inhaled therapy in elderly COPD patients; time for re-evaluation? Age Ageing. 2007; 36(2): 213–218.
  28. Monninkhof EM, van der Valk PD, van der Palen J, et al. Self-management education for chronic obstructive pulmonary disease. Cochrane Database Syst Rev. 2007(1): CD002990.
  29. Effing T, Kerstjens H, van der Valk P, et al. (Cost)-effectiveness of self-treatment of exacerbations on the severity of exacerbations in patients with COPD: the COPE II study. Thorax. 2009; 64(11): 956–962.
  30. Garcia-Aymerich J, Hernandez C, Alonso A, et al. Effects of an integrated care intervention on risk factors of COPD readmission. Respir Med. 2007; 101(7): 1462–1469.
  31. Casas A, Troosters T, Garcia-Aymerich J, et al. members of the CHRONIC Project. Integrated care prevents hospitalisations for exacerbations in COPD patients. Eur Respir J. 2006; 28(1): 123–130.
  32. www.who.int/entity/mediacentre/factsheete/fs172/en/ (11.2009).
  33. Krajnik M, Buczkowski K. Definicja i filozofia opieki paliatywnej. In: Krajnik M, Buczkowski K. ed. Opieka paliatywna. Wydawnictwo Lekarskie PZWL, Warszawa 2009.
  34. Krakowiak P, Modlińska A, Binnebesel J. Podręcznik koordynatora wolontariatu hospicyjnego. Via Medica, Gdańsk 2008.
  35. Krakowiak P, Modlinska A. Podręcznik wolontariusza hospicyjnego. Via Medica, Gdańsk 2008.
  36. ada Europy. Wytyczne (2003) komitetu Ministrów dla państw członkowskich dotyczące organizacji opieki paliatywnej. Memorandum wyjaśniające. (tłumaczenie) J. Łuczak (red.). Poznań, 2004.
  37. Ferrell B, Coyle N. Textbook of palliative nursing. Wyd 2. Oxford University Press 2006: 35–36.
  38. Krakowiak P. Strata, osierocenie, żałoba. Poradnik dla pomagających i dla osób w żałobie. Via Medica, Gdańsk 2007.
  39. Damps-Konstańska I, Werachowska L, Krakowiak P. Rola opiekuna medycznego i wolontariusza w opiece nad chorymi na zaawansowaną postać przewlekłej obturacyjnej choroby płuc (POChP). Med Paliat Prakt. 2009; 3: 150–156.
  40. Viktoria Stein K, Rieder A. Integrated care at the crossroads-defining the way forward. Int J Integr Care. 2009; 9: 1–7.

Important: This website uses cookies. More >>

The cookies allow us to identify your computer and find out details about your last visit. They remembering whether you've visited the site before, so that you remain logged in - or to help us work out how many new website visitors we get each month. Most internet browsers accept cookies automatically, but you can change the settings of your browser to erase cookies or prevent automatic acceptance if you prefer.

Czasopismo Pneumonologia i Alergologia Polska dostęne jest również w Ikamed - księgarnia medyczna

Wydawcą serwisu jest "Via Medica sp. z o.o." sp.k., ul. Świętokrzyska 73, 80–180 Gdańsk

tel.:+48 58 320 94 94, faks:+48 58 320 94 60, e-mail: viamedica@viamedica.pl