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End-of-life care in oxygen-dependent ILD compared with lung cancer: a national population-based study
Univ Lund Hosp, Dept Clin Sci, Div Resp Med & Allergol, SE-22100 Lund, Sweden..
Duke Univ, Duke Clin Res Inst, Ctr Learning Hlth Care, Div Pulm Allergy & Crit Care,Dept Med, Durham, NC USA..
Stockholms Sjukhem Fdn, Palliat Care Serv, Stockholm, Sweden..
Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Medical Sciences, Respiratory Medicine and Allergology.
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2016 (English)In: Thorax, ISSN 0040-6376, E-ISSN 1468-3296, Vol. 71, no 6, 510-516 p.Article in journal (Refereed) Published
Abstract [en]

Rationale: Advanced fibrosing interstitial lung disease (ILD) is often progressive and associated with a high burden of symptoms and poor prognosis. Little is known about the symptom prevalence and access to palliative care services at end of life (EOL).

Objectives: Compare prevalence of symptoms and palliative treatments between patients dying with oxygen-dependent ILD and patients dying of lung cancer.

Methods: Nationwide registry-based cohort study of patients with oxygen-dependent ILD and patients with lung cancer who died between 1 January 2011 and 14 October 2013. Prevalence of symptoms and treatments during the last seven days of life were compared using data in Swedish Registry of Palliative Care.

Measurements and main results: 285 patients with ILD and 10 822 with lung cancer were included. In ILD, death was more likely to be 'unexpected' (15% vs 4%), less likely to occur in a palliative care setting (17% vs 40%) and EOL discussions with the patients (41% vs 59%) were less common than in lung cancer. Patients with ILD suffered more from breathlessness (75% vs 42%) while patients with lung cancer had more pain (51% vs 73%) (p<0.005 for all comparisons). Patients with ILD had more unrelieved breathlessness, pain and anxiety. The survival time from initiation of oxygen therapy in ILD was a median 8.4 months (IQR 3.4-19.2 months).

Conclusions: Patients with ILD receive poorer access to specialist EOL care services and experience more breathlessness than patients with lung cancer. This study highlights the need of better EOL care in oxygen-dependent ILD.

Place, publisher, year, edition, pages
2016. Vol. 71, no 6, 510-516 p.
National Category
Medical and Health Sciences
Identifiers
URN: urn:nbn:se:uu:diva-302242DOI: 10.1136/thoraxjnl-2015-207439ISI: 000376658400007PubMedID: 26865603OAI: oai:DiVA.org:uu-302242DiVA: diva2:957220
Funder
Swedish Society of MedicineSwedish Heart Lung Foundation
Available from: 2016-09-01 Created: 2016-08-31 Last updated: 2016-09-01Bibliographically approved

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