Chronic obstructive pulmonary disease

Abstract

Chronic obstructive pulmonary disease (COPD) is one of the commonest causes of death worldwide. It causes substantial disability which progresses over many years. Patients need a high level of treatment and supportive care throughout the course of the disease. A key goal of treatment is to improve patient-centered outcomes such as quality of life, symptom burden, and the impact of symptoms on the patient's overall functioning. Palliative care of COPD is particularly complex because of the clinical course of the disease over many years, the unpredictable trajectory of the disease and the fact that patients often die from other causes. End of life issues and anticipatory care planning should be discussed in patients with advanced COPD but disease-specific therapies, emergency management of exacerbations, and palliative supportive care must run in parallel in an integrated manner. The dying phase is often short, over a few days, when the patient fails to recover from the final exacerbation.