• Kim Beernaert, Joachim Cohen, Luc Deliens, Dirk Devroey, Katrien Vanthomme, Koen Pardon, and Lieve Van den Block.
• End-of-Life Care Research Group, Vrije Universiteit Brussel & Ghent University, Laarbeeklaan 103, 1090 Jette, Belgium. Electronic address: kim.beernaert@vub.ac.be.
• Respir Med. 2013 Nov 1;107(11):1731-9.

AimTo describe how patients with COPD, heart failure, dementia and cancer differ in frequency and timing of referral to palliative care services.MethodsWe performed a population-based study with the Sentinel Network of General Practitioners in Belgium. Of 2405 registered deaths respectively 5%, 4% and 28% were identified as from COPD, heart failure or cancer and 14% were diagnosed with severe dementia. GPs reported use and timing of palliative care services and treatment goals in the final three months of life.ResultsPatients with COPD (20%) were less likely than those with heart failure (34%), severe dementia (37%) or cancer (60%) to be referred to palliative care services (p < 0.001). The median days between referral and death was respectively 10, 12, 14 and 20. Patients with COPD who were not referred more often received treatment with a curative or life-prolonging goal and less often with a palliative or comfort goal than did the other patients who were not referred.ConclusionPatients with COPD are underserved in terms of palliative care compared to those with other chronic life-limiting diseases. Awareness of palliative care as an option for patients with COPD needs to increase in palliative care services, physicians and the general public.Copyright © 2013 Elsevier Ltd. All rights reserved.

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