COPD & Palliative Care The British Lung Foundation Scotland - - PDF document

▶
copd amp palliative care
SMART_READER_LITE
LIVE PREVIEW

COPD & Palliative Care The British Lung Foundation Scotland - - PDF document

Aug 23, 2023 297 likes •401 views

Cross Party Group in the Scottish Parliament on Palliative Care COPD & Palliative Care The British Lung Foundation Scotland Information S upport Campaigning Research Wednesday 5 March 2008 1 Cross Party Group in the

slide-1
SLIDE 1

Cross Party Group in the Scottish Parliament on Palliative Care Wednesday 5 March 2008 1

COPD & Palliative Care

The British Lung Foundation Scotland

  • Information
  • S

upport

  • Campaigning
  • Research
slide-2
SLIDE 2

Cross Party Group in the Scottish Parliament on Palliative Care Wednesday 5 March 2008 2

What is COPD?

  • Chronic obstructive pulmonary disease (COPD) is a

disease state characterised by airflow limitation that is not fully reversible. The airflow limitation is usually both progressive and associated with an abnormal inflammatory response of the lungs to noxious particles or gases.

Causes of COPD

  • 80%

+ smoking related

  • Occupational
  • Environmental
  • Genetic
slide-3
SLIDE 3

Cross Party Group in the Scottish Parliament on Palliative Care Wednesday 5 March 2008 3

Prevalence of COPD

Percent Change in Age-Adj usted Death Rates, U.S ., 1965-1998 Percent Change in Age-Adj usted Death Rates, U.S ., 1965-1998 –59% –59% –64% –64% –35% –35% +163% +163% –7% –7% Coronary Heart Disease Coronary Heart Disease Stroke Stroke Other CVD Other CVD COPD COPD All Other Causes All Other Causes

Source: NHLBI/NIH/DHHS Source: NHLBI/NIH/DHHS 2 4 6 8 10 12 Acute myocardial infarction Chronic ischaemic heart disease Malignant neoplasm of bronchus and lung Other chronic obstructive pulmonary disease Pneumonia, organism unspecified Stroke, not specified as haemorrhage or infarction Unspecified dementia Sequelae of cerebrovascular disease Malignant neoplasm of breast Malignant neoplasm without specification of site (% )

10 Most common causes of death (Scotland) 2003-2005

slide-4
SLIDE 4

Cross Party Group in the Scottish Parliament on Palliative Care Wednesday 5 March 2008 4

COPD - PTI Contacts

20,000 40,000 60,000 80,000 100,000 120,000 140,000 2003/04 2004/05 Male Female

  • Primary care data suggests over 90,000 people living with COPD in Scotland

Prevalence & mortality of COPD in Scotland

Prevalence by healthboard

COPD - Prevalence per 1000 5 10 15 20 25 30 Argyll & Clyde Ayrshire & Arran Borders Dumfries & Galloway Fife Forth Valley Grampian Greater Glasgow Highland Lanarkshire Lothian Orkney Shetland Tayside Western Isles Scotland

04/05 05/06

slide-5
SLIDE 5

Cross Party Group in the Scottish Parliament on Palliative Care Wednesday 5 March 2008 5

Prevalence & Mortality of COPD in Scotland?

  • Primary care data suggests over 90,000 people living with

COPD in Scotland

3,600 3,800 4,000 4,200 4,400 4,600 1997 1998 1999 2000 2001 Number of deaths

Epidemiology of COPD

2 0 0 4 0 0 6 0 0 8 0 0 1 0 0 0

  • 4

1

  • 1

4 2

  • 2

4 3

  • 3

4 4

  • 4

4 5

  • 5

4 6

  • 6

4 7

  • 7

4 8

  • 8

4

A g e b a n d New cases in 2001

slide-6
SLIDE 6

Cross Party Group in the Scottish Parliament on Palliative Care Wednesday 5 March 2008 6

Who is living with and dying from COPD

Dep Cat Episodes per 10,000 people 1 (affluent) 563 19 2 1,697 24 3 2,951 27 4 4,031 32 5 3,004 40 6 2,446 45 7 (deprived) 2,509 74 All 17,201 34

Hospital use by Deprivation Category

The Changing Political Context

  • Not a national priority
  • Developing clinical standards
  • Recognition of the needs of patients
  • Awareness that we need to do

“ something” about non-malignant palliative care

slide-7
SLIDE 7

Cross Party Group in the Scottish Parliament on Palliative Care Wednesday 5 March 2008 7

The real burden of disease

  • Isolation and depression
  • Fear and anxiety
  • Low expectations
  • Quality of life
  • Access to services

What are the palliative care needs of patients with CLD?

94% Dyspnoea 78% 77% Pain 85% 59% Cough 56% 47% Sickness 46% 68% Anorexia 76% 44% Constipation 59% 65% Insomnia 60% 71% Low Mood 68%

Edmonds, Pall Med 2001;15:287-285

S ymptom Burden

Lung Cancer Chronic Lung Disease

slide-8
SLIDE 8

Cross Party Group in the Scottish Parliament on Palliative Care Wednesday 5 March 2008 8

What are the palliative care needs of patients with CLD?

COPD vs Lung Cancer; quality of life

  • Anxiety/Depression levels higher
  • Quality of life poorer including pain
  • Information needs not met both groups
  • Social support lacking for both in community
  • Specialist palliative care lung cancer only
  • COPD intermittent support from respiratory nurse

Gore Thorax 2000 ; 55: 1000-6

Why do we find palliative care for respiratory patients so difficult?

  • Terminal phase difficult to define
  • Many near death episodes
  • Palliative Care is for cancer patients only
  • Palliative care is only for the dying
  • Very low patient expectations
slide-9
SLIDE 9

Cross Party Group in the Scottish Parliament on Palliative Care Wednesday 5 March 2008 9 Results for patients

LC patients knew they were dying LC more likely to die in a hospice CLD die in hospital CLD

  • ften die within 24hrs of admission

CLD needed more help with self care LC more community nurse & palliative Care

Edmonds et al Pall Med 2001;15 287-295

What patients do NOT want to hear

  • Its too difficult
  • We’ ll get “ swamped”
  • Their j ourney is wrong

What patients want to hear

  • The same as…

… … … … … … … … … … .