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

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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)

Article type

Review paper

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

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