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Caring for the patient with advanced chronic obstructive pulmonary disease 

Caring for the patient with advanced chronic obstructive pulmonary disease
Chapter:
Caring for the patient with advanced chronic obstructive pulmonary disease
Author(s):

Graeme M. Rocker

, Joanne Michaud-Young

, and Robert Horton

DOI:
10.1093/med/9780199656097.003.0152
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date: 07 May 2021

The global prevalence of chronic obstructive pulmonary disease (COPD) is high and rising. Patients and families living with advanced disease often experience biopsychosocial symptom burdens over a long trajectory, leaving them housebound when they require support the most. Current models of care, by placing a disproportionate focus on the provision of acute and facility-based services, do little to address the complex needs of those vulnerable patients and families who struggle to easily access primary care services. This chapter provides an overview of conventional COPD treatments and highlights some newer understandings and management approaches for patients living with high symptom burden despite optimized conventional treatments, including the use of opioids. It provides some concrete examples of models of care that employ interventions and holistic approaches to care that can improve patient and family outcomes. The move towards an integrated care approach to COPD will help patients and their families reach informed decisions about their care throughout the trajectory of COPD.

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