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Consensus palliative care referral criteria for people with chronic obstructive pulmonary disease

Philip, Jennifer ; Chang, Yuchieh Kathryn ; Collins, Anna ; Smallwood, Natasha ; Sullivan, Donald Richard ; Yawn, Barbara P. ; Mularski, Richard ; Ekström, Magnus LU orcid ; Yang, Ian A. and McDonald, Christine F. , et al. (2024) In Thorax 79(11). p.1006-1016
Abstract

Objective People with advanced chronic obstructive pulmonary disease (COPD) have substantial palliative care needs, but uncertainty exists around appropriate identification of patients for palliative care referral. We conducted a Delphi study of international experts to identify consensus referral criteria for specialist outpatient palliative care for people with COPD. Methods Clinicians in the fields of respiratory medicine, palliative and primary care from five continents with expertise in respiratory medicine and palliative care rated 81 criteria over three Delphi rounds. Consensus was defined a priori as ≥70% agreement. A criterion was considered’major’ if experts endorsed meeting that criterion alone justified palliative care... (More)

Objective People with advanced chronic obstructive pulmonary disease (COPD) have substantial palliative care needs, but uncertainty exists around appropriate identification of patients for palliative care referral. We conducted a Delphi study of international experts to identify consensus referral criteria for specialist outpatient palliative care for people with COPD. Methods Clinicians in the fields of respiratory medicine, palliative and primary care from five continents with expertise in respiratory medicine and palliative care rated 81 criteria over three Delphi rounds. Consensus was defined a priori as ≥70% agreement. A criterion was considered’major’ if experts endorsed meeting that criterion alone justified palliative care referral. Results Response rates from the 57 panellists were 86% (49), 84% (48) and 91% (52) over first, second and third rounds, respectively. Panellists reached consensus on 17 major criteria for specialist outpatient palliative care referral, categorised under: (1)’Health service use and need for advanced respiratory therapies’ (six criteria, eg, need for home non-invasive ventilation); (2)’Presence of symptoms, psychosocial and decision-making needs’ (eight criteria, eg, severe (7–10 on a 10 point scale) chronic breathlessness); and (3)’Prognostic estimate and performance status’ (three criteria, eg, physician-estimated life expectancy of 6 months or less). Conclusions International experts evaluated 81 potential referral criteria, reaching consensus on 17 major criteria for referral to specialist outpatient palliative care for people with COPD. Evaluation of the feasibility of these criteria in practice is required to improve standardised palliative care delivery for people with COPD.

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publishing date
type
Contribution to journal
publication status
published
subject
in
Thorax
volume
79
issue
11
pages
11 pages
publisher
BMJ Publishing Group
external identifiers
  • pmid:39174326
  • scopus:85204376600
ISSN
0040-6376
DOI
10.1136/thorax-2024-221721
language
English
LU publication?
yes
id
390fae6f-9d3a-4c13-8ae3-2901bcceafac
date added to LUP
2024-12-02 13:56:18
date last changed
2025-07-01 18:43:28
@article{390fae6f-9d3a-4c13-8ae3-2901bcceafac,
  abstract     = {{<p>Objective People with advanced chronic obstructive pulmonary disease (COPD) have substantial palliative care needs, but uncertainty exists around appropriate identification of patients for palliative care referral. We conducted a Delphi study of international experts to identify consensus referral criteria for specialist outpatient palliative care for people with COPD. Methods Clinicians in the fields of respiratory medicine, palliative and primary care from five continents with expertise in respiratory medicine and palliative care rated 81 criteria over three Delphi rounds. Consensus was defined a priori as ≥70% agreement. A criterion was considered’major’ if experts endorsed meeting that criterion alone justified palliative care referral. Results Response rates from the 57 panellists were 86% (49), 84% (48) and 91% (52) over first, second and third rounds, respectively. Panellists reached consensus on 17 major criteria for specialist outpatient palliative care referral, categorised under: (1)’Health service use and need for advanced respiratory therapies’ (six criteria, eg, need for home non-invasive ventilation); (2)’Presence of symptoms, psychosocial and decision-making needs’ (eight criteria, eg, severe (7–10 on a 10 point scale) chronic breathlessness); and (3)’Prognostic estimate and performance status’ (three criteria, eg, physician-estimated life expectancy of 6 months or less). Conclusions International experts evaluated 81 potential referral criteria, reaching consensus on 17 major criteria for referral to specialist outpatient palliative care for people with COPD. Evaluation of the feasibility of these criteria in practice is required to improve standardised palliative care delivery for people with COPD.</p>}},
  author       = {{Philip, Jennifer and Chang, Yuchieh Kathryn and Collins, Anna and Smallwood, Natasha and Sullivan, Donald Richard and Yawn, Barbara P. and Mularski, Richard and Ekström, Magnus and Yang, Ian A. and McDonald, Christine F. and Mori, Masanori and Perez-Cruz, Pedro and Halpin, David M.G. and Cheng, Shao Yi and Hui, David}},
  issn         = {{0040-6376}},
  language     = {{eng}},
  number       = {{11}},
  pages        = {{1006--1016}},
  publisher    = {{BMJ Publishing Group}},
  series       = {{Thorax}},
  title        = {{Consensus palliative care referral criteria for people with chronic obstructive pulmonary disease}},
  url          = {{http://dx.doi.org/10.1136/thorax-2024-221721}},
  doi          = {{10.1136/thorax-2024-221721}},
  volume       = {{79}},
  year         = {{2024}},
}