Palliative Care

Defined by the World Health Organisation (WHO) as:

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“An approach that improves the quality of life of patients and their families facing the problems associated with life-threatening illness, through the prevention and relief of suffering by means of early identification and impeccable assessment and treatment of pain and other problems including physical, psychosocial and spiritual issues.”

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The accessibility of these services is often less for COPD patients than cancer patients. Alleviation of symptoms such as anxiety, depression, cough, dry mouth. Viscous secretions, fatigue and dyspnoea should be a priority in palliative care of COPD patients. These patients should be able to access the range of services offered by palliative care multidisciplinary teams, including access to hospices.

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Opioids can be used to treat dyspnoea in end-stage COPD which has been unresponsive to other treatments. A Cochrane review showed that oral and parenteral opioids are both effective, however, nebulised opioids had no effect.  In many COPD patients opioids have shown to reduce breathlessness by around 20%. Other possible treatments include the use of benzodiazepines, tricyclic antidepressants and oxygen.