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Title: Advance care planning for individuals with chronic obstructive pulmonary disease: a scoping review of the literature.
Austin Authors: Meehan, Elaine;Foley, Tony;Kelly, Ms Claire;Burgess Kelleher, Art;Sweeney, Catherine;Hally, Ruth M;Detering, Karen M ;Cornally, Nicola
Affiliation: School of Nursing and Midwifery, University College Cork, Cork, Ireland
Advance Care Planning Australia, Austin Health, Heidelberg, Victoria, Australia
School of Medicine, University College Cork, Cork, Ireland
Issue Date: Jun-2020
Date: 2019-12-11
Publication information: Journal of pain and symptom management 2020; 59(6): 1344-1361
Abstract: Individuals with chronic obstructive pulmonary disease (COPD) typically experience a gradual worsening of the illness in the years prior to death. Due to difficulties in predicting the disease trajectory or the timing of acute exacerbations, advance care planning (ACP) may be of particular importance for individuals with COPD. To review and summarise the available literature on current practices around ACP in COPD. A scoping review of the literature was conducted following the Arksey and O'Malley framework . Original research studies of any design were included. Twenty-eight studies were included. Across studies, there was agreement that ACP should be incorporated into routine COPD management. There was evidence that this does not occur in everyday practice, with conversations tending to focus on day-to-day symptom management. Barriers included prognosis uncertainty, insufficient time and training, and a lack of protocols for who is responsible for initiating ACP. Facilitators included the use of transition points for identifying the appropriate time to initiate ACP, and an increased focus on ACP in professional education. The occurrence of repeated episodes of acute care was identified as a key transition point for identifying the palliative stage of COPD and an appropriate time to initiate ACP. The findings of this review confirm agreement among healthcare professionals and patients with COPD and their carers that ACP should be incorporated into routine COPD management. The use of transition points may help healthcare professionals overcome the barrier of prognosis uncertainty, and identify patients that might benefit from ACP.
DOI: 10.1016/j.jpainsymman.2019.12.010
ORCID: 0000-0002-1884-7272
Journal: Journal of pain and symptom management
PubMed URL: 31837455
Type: Journal Article
Subjects: COPD
advance care planning
chronic obstructive pulmonary disease
scoping review
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