• J Pain Symptom Manage · Jun 2024

    Review

    Criteria for Enrollment of Patients with COPD in Palliative Care Trials: A Systematic Review.

    • Natalia Smirnova, Allison V Lange, Amanda Glickman, Kristen Desanto, Cara L McDermott, Donald R Sullivan, David B Bekelman, and Dio Kavalieratos.
    • Division of Pulmonary, Allergy and Critical Care Medicine (N.S.), Emory University School of Medicine, Atlanta, Georgia, USA.
    • J Pain Symptom Manage. 2024 Jun 1; 67 (6): e891e905e891-e905.

    ContextUse of palliative care interventions in chronic obstructive pulmonary disease (COPD) has increased in recent years and inclusion criteria used to identify patients with COPD appropriate for palliative care vary widely. We evaluated the inclusion criteria to identify ways to improve enrollment opportunities for patients with COPD.ObjectivesTo determine inclusion criteria used to select patients with COPD for palliative care trials.MethodsA systematic review was conducted to determine criteria used to select patients with COPD for palliative care randomized controlled trials. A narrative synthesis was conducted for all trials.ResultsInclusion criteria were highly heterogeneous. Most studies (n = 11, 79%) used a combination of criteria to identify patients with COPD. Commonly used criteria included hospitalization for an acute exacerbation of COPD (n = 8, 57%), home supplemental oxygen use (n = 8, 57%), and spirometry values confirming COPD (n = 6, 43%). Three studies (21.4%) used Modified Medical Research Council score and two studies (21%) used physician prognosis or a performance scale.ConclusionThe most common criteria, a hospitalization for acute exacerbation of COPD or supplemental oxygen use at home, both have the benefit of selecting patients who have a higher symptom burden or higher healthcare utilization who might therefore benefit more from palliative care. By describing the landscape and variability of previously used inclusion criteria, this article serves as a resource for clinicians and researchers. Developing a consistent set of inclusion criteria in the future would help generate generalizable results that can be translated into clinical practice to improve the lives of patients with COPD.Prospero Registration NumberCRD42022306752.Copyright © 2024 American Academy of Hospice and Palliative Medicine. All rights reserved.

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