Palliative care integration in advanced chronic obstructive pulmonary disease: are we ready?

Background: Chronic obstructive pulmonary disease (COPD) is a life-limiting condition with intrinsic unpredictability and developing palliative care needs along the disease trajectory. Despite increasing evidence about the important role that palliative care plays in care delivery for patients with advanced COPD, its accessibility and integration remain underdeveloped. Several factors influence the development of integrated care initiatives for patients with advanced COPD, such as misconceptions about palliative care and different modalities of care provision.Aim: To identify, retrieve and summarise the available body of knowledge on palliative care integration in advanced COPD. Methods: A narrative literature review was conducted following pre-defined quality criteria for this type of literature review. Six electronic databases were searched using a comprehensive search strategy to identify studies on palliative care integration in advanced COPD, published from January 1, 1960 to October 31, 2021.Results: Twenty-six studies were included in the literature review. Of these papers, 12 adopted a qualitative approach, 12 adopted a quantitative approach and two were mixed-methods studies. Different aspects of integrated palliative care were considered in these papers, such as accessibility to care integration, patients', informal caregivers' and healthcare professionals' perceptions and experiences on integrated care initiatives, clinical and non-clinical outcomes of integrated care initiatives and development of new conceptual models for integrated care delivery. Conclusion: This narrative literature review highlighted several key aspects of palliative care integration in advanced COPD, such as promoting accessibility through identification of patients' needs, improving communication between healthcare providers and with patients and their families, and fostering effective advance care planning and coordination of services. Further research is needed to encourage a broader understanding of the challenges that are related to palliative care integration in advanced COPD and to support the development of new integrated care initiative in all settings.