• Daniel Gainza-Miranda, Eva Maria Sanz-Peces, Alberto Alonso-Babarro, María Varela-Cerdeira, Concepción Prados-Sánchez, Guadalupe Vega-Aleman, Ricardo Rodriguez-Barrientos, and Elena Polentinos-Castro.
• 1 Palliative Homecare Team Northern Area of Madrid, SERMAS , San Sebastian de los Reyes, Spain .
• J Palliat Med. 2019 Mar 1; 22 (3): 290296290-296.

Background And AimConsensus has been reached on the need to integrate palliative care in the follow-up examinations of chronic obstructive pulmonary disease (COPD) patients. We analyzed the survival from the initiation of follow-up by a palliative home care team (PHCT) and described the needs and end-of-life process.Setting And DesignThis study was a prospective observational cohort study of advanced COPD patients referred to a PHCT. Sociodemographic variables, survival from the start date of follow-up using the Kaplan-Meier model, health resource consumption, perceived quality of life, main symptomatology, opioid use, and advanced care planning (ACP) were analyzed.ResultsSixty patients were included. The median survival was 8.3 months. Forty-two patients died at the end of the study (85% at home or in palliative care units). The most frequent cause of death was respiratory failure in 39 patients (93%), with 29 of these patients requiring sedation (69%). Dyspnea at rest, with an average of 5 (standard deviation [SD] 2) points, was the main symptom. Fifty-five patients (91%) required opioids for symptom control. The median score in the St. George's Respiratory Questionnaire was 72 (SD 13). The mean number of visits by the home team was 7 (SD 6.5). The mean number of admissions during the monitoring period was 1.5 (SD 0.15).ConclusionsThe characteristics of the cohort appear suitable for a PHCT. The follow-up care provided by our multidisciplinary unit decreased the number of hospitalizations, favored the development of ACP, and enabled death at home or in palliative care units.

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