|Evaluating Palliative Care Referral and Mortality Rates in St Michael’s COPD Outreach Service
|D.Kuda K.O' Sullivan S.O'Beirne P.Gregan
|St Michael's Hospital
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|Asthma and COPD
|Despite the important role of palliative care (PC) in the management of patients with chronic obstructive pulmonary disease (COPD), it is frequently under-utilised and is not offered to the majority of patients with advanced disease1,2.
To examine the utilisation of PC services in the cohort of patients supported by the COPD Outreach Service in St Michael’s Hospital, a retrospective analysis of the service from July 2019 to July 2020 was performed. The majority of patients had attended the emergency department and/or been hospitalised with a COPD exacerbation in the preceding year, markers of poor prognosis.
A total of 168 patients engaged with the service during this period, with ten deaths occurring (5.9% mortality rate) half of which were attributed to COPD. Chart review of deceased patients’ medical records revealed 50% had severe disease based on spirometric criteria and overall 70% of them had been referred to PC services.
This finding is encouraging, given the low overall PC referral rates reported1,2. This and the low mortality rate in the cohort may be related at least in part to the involvement of a COPD outreach team providing support and continuity of care for individuals with advanced COPD in the community.