• Johanna Broese, Rianne Mjj van der Kleij, VerschuurEls MlEMLung Alliance Netherlands, Amersfoort, The Netherlands., Huib Am Kerstjens, Ewald M Bronkhorst, Yvonne Engels, and Niels H Chavannes.
• Department of Public Health and Primary Care, Leiden University Medical Centre, Leiden, The Netherlands.
• Palliat Med. 2023 Jun 1; 37 (6): 844855844-855.

BackgroundCOPD causes high morbidity and mortality, emphasizing the need for palliative care.AimTo assess the effectiveness of palliative care in patients with COPD.DesignCluster randomized controlled trial (COMPASSION study; Netherlands Trial Register (NTR): NL7644, 07-04-2019). Healthcare providers within the intervention group were trained to implement palliative care components into routine COPD care. Patients completed questionnaires at baseline, after 3 and 6 months; medical records were assessed after 12 months. The primary outcome was quality of life (FACIT-Pal). Secondary outcomes were anxiety, depression, spiritual well-being, satisfaction with care, acute healthcare use, documentation of life-sustaining treatment preferences and place of death. Generalized linear mixed modelling was used for analyses.SettingEight hospital regions in the Netherlands.ParticipantsPatients hospitalized for an acute exacerbation of COPD and positive ProPal-COPD score.ResultsOf 222 patients included, 106 responded to the questionnaire at 6 months. Thirty-six of 98 intervention patients (36.7%) received the intervention. Intention-to-treat-analysis showed no effect on the primary outcome (adjusted difference: 1.09; 95% confidence interval: -5.44 to 7.60). In the intervention group, fewer intensive care admissions for COPD took place (adjusted odds ratio: 0.21; 95% confidence interval: 0.03-0.81) and strong indications were found for fewer hospitalizations (adjusted incidence rate ratio: 0.69; 95% confidence interval: 0.46-1.03).ConclusionsWe found no evidence that palliative care improves quality of life in patients with COPD. However, it can potentially reduce acute healthcare use. The consequences of the COVID-19 pandemic led to suboptimal implementation and insufficient power, and may have affected some of our findings.

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