Vol 78, No 2 (2010)
REVIEWS
Published online: 2010-03-19
Submitted: 2013-02-22
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.
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
Keywords
chronic obstructive pulmonary disease (COPD); integrated treatment; coordinator; palliative care
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
About this article