1. COPD patients’ preferences and clinicians’ judgements for palliative care conversations
Background: Only 30% of patients with Chronic Obstructive Pulmonary Disease discuss palliative care with clinicians. When conversations do take place, they usually happen during a hospital admission when patients are very unwell and are unable to fully express their preferences. Clinicians do not know when and how to start and conduct conversations with patients.
Aim: To explore the timing and nature of palliative care conversations in COPD.
Methods: The study is divided into 3 different phases, which include:
Phase 1 - Systematic literature review about palliative care conversations in COPD. This step has been completed and the review has been published in an international respiratory journal - Tavares, N., et al. (2017 (in press)). "Palliative and end of life care conversations in COPD - a systematic literature review." ERJ - Open Research.
Phase 2 – Interviews and case-note review of COPD patients in 3 different stages of disease severity: mild, moderate and severe. Each group will contain 7-10 patients and interviews will be stopped at data saturation point. Phase 2 aims to understand patients’ preferences for palliative care conversations with clinicians and the meaning attributed to COPD and palliative care.
Phase 3 – Interviews will be conducted with the following groups of clinicians: respiratory consultants and registrars, nurses, physiotherapists and GPs. Vignettes with patients’ clinical and social data, as well as, preferences for palliative care discussions will be presented to clinicians. This phase will help to understand factors that impact in clinicians’ judgements when starting and conducting discussions.
Results: REC ethics approval received. Currently, waiting for HRA approval to start data collection.
Please use the dd month yyyy format for the date for example 11 January The main title can be one or two lines long.
Nuno Tavares
Dr Katherine Hunt, Dr Nikki Jarrett and Dr Tom Wilkinson 8th February 2017