Case study:

06 April 2008

Understanding Chronic Obstructive Pulmonary Disease (COPD) patients’ decisions regarding future treatment

Key points

Discussions about end of life treatment need to be carefully tailored to individual needs, according to a study of COPD patients by the National Heart and Lung Institute at Charing Cross Hospital.

The study, which was designed to discover how far COPD patients wished to be involved in decisions about end of life care, involved three focus groups of patients whose condition had led to hospitalisation.

It revealed that patients had mixed views about when it was appropriate to discuss future treatment and some were in denial about their disease.

However, most felt it was clearly inappropriate to discuss these issues when they were ill and in hospital.

The authors suggest the best time for this conversation might be at the first review after discharge and this could be aided if patients are given some reading or viewing material in advance to help them think about the issues.

A leaflet containing helpful information about end of life issues is currently being designed and tested within the Imperial College NHS healthcare trust.

The study indicates that at the moment communication between doctors and patients is often ‘sub-optimal’.

But most patients said they would prefer to discuss end of life issues with their consultant – or failing that their GP or a respiratory nurse.

The study was funded by the NW Strategic Health Authority End of Life Care project.