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dc.contributor.authorSmallwood, N
dc.contributor.authorThompson, M
dc.contributor.authorWarrender-Sparkes, M
dc.contributor.authorEastman, P
dc.contributor.authorLe, B
dc.contributor.authorIrving, L
dc.contributor.authorPhilip, J
dc.date.accessioned2020-12-18T04:22:38Z
dc.date.available2020-12-18T04:22:38Z
dc.date.issued2018-01-01
dc.identifierpii: 00102-2017
dc.identifier.citationSmallwood, N., Thompson, M., Warrender-Sparkes, M., Eastman, P., Le, B., Irving, L. & Philip, J. (2018). Integrated respiratory and palliative care may improve outcomes in advanced lung disease. ERJ OPEN RESEARCH, 4 (1), https://doi.org/10.1183/23120541.00102-2017.
dc.identifier.issn2312-0541
dc.identifier.urihttp://hdl.handle.net/11343/256168
dc.description.abstractThe unaddressed palliative care needs of patients with advanced, nonmalignant, lung disease highlight the urgent requirement for new models of care. This study describes a new integrated respiratory and palliative care service and examines outcomes from this service. The Advanced Lung Disease Service (ALDS) is a long-term, multidisciplinary, integrated service. In this single-group cohort study, demographic and prospective outcome data were collected over 4 years, with retrospective evaluation of unscheduled healthcare usage. Of 171 patients included, 97 (56.7%) were male with mean age 75.9 years and 142 (83.0%) had chronic obstructive pulmonary disease. ALDS patients had severely reduced pulmonary function (median (interquartile range (IQR)) forced expiratory volume in 1 s 0.8 (0.6-1.1) L and diffusing capacity of the lung for carbon monoxide 37.5 (29.0-48.0) % pred) and severe breathlessness. All patients received nonpharmacological breathlessness management education and 74 (43.3%) were prescribed morphine for breathlessness (median dose 9 mg·day-1). There was a 52.4% reduction in the mean number of emergency department respiratory presentations in the year after ALDS care commenced (p=0.007). 145 patients (84.8%) discussed and/or completed an advance care plan. 61 patients died, of whom only 15 (24.6%) died in an acute hospital bed. While this was a single-group cohort study, integrated respiratory and palliative care was associated with improved end-of-life care and reduced unscheduled healthcare usage.
dc.languageEnglish
dc.publisherEUROPEAN RESPIRATORY SOC JOURNALS LTD
dc.rights.urihttps://creativecommons.org/licenses/by-nc/4.0
dc.titleIntegrated respiratory and palliative care may improve outcomes in advanced lung disease
dc.typeJournal Article
dc.identifier.doi10.1183/23120541.00102-2017
melbourne.affiliation.departmentAnatomy and Neuroscience
melbourne.affiliation.departmentMedicine (RMH)
melbourne.affiliation.departmentMedicine (St Vincent's)
melbourne.affiliation.facultyMedicine, Dentistry & Health Sciences
melbourne.source.titleERJ Open Research
melbourne.source.volume4
melbourne.source.issue1
dc.rights.licenseCC BY-NC
melbourne.elementsid1313749
melbourne.contributor.authorIrving, Louis
melbourne.contributor.authorLe, Brian
melbourne.contributor.authorPhilip, Jennifer
melbourne.contributor.authorSmallwood, Natasha
dc.identifier.eissn2312-0541
melbourne.accessrightsOpen Access


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