Chest
Ethics in Cardiopulmonary MedicineBarriers and Facilitators to End-of-Life Care Communication for Patients with COPD
Section snippets
Participant Recruitment and Enrollment
We report results of a cross-sectional analysis of a prospective study of patients with oxygen-dependent COPD recruited from ambulatory clinics at a university, county, and Veterans Affairs (VA) teaching hospital, and an oxygen delivery company in Seattle, WA. The methods have been described previously in an article10 describing the quality of communication about end-of-life care and an article11 describing the role of depression and quality of life on treatment preferences for life-sustaining
Results
Of the 295 eligible patients contacted, 118 patients were initially enrolled in the study for 40% participation. Of the 118 enrolled patients, 3 patients were unable to complete interviews due to fatigue, leaving a sample size of 115 patients. At the two study sites where a clinician familiar with the patient introduced the study, 78 eligible patients were identified, and 50 patients were enrolled for a participation rate of 64%. At the two study sites where patients were sent a mailing
Occurrence of Communication About End-of-Life Care
This study suggests that only one third (32%) of the patients with oxygen-dependent COPD discuss with their physicians the type of care they would want if they were too sick to speak for themselves. Even the lower limit of the 95% confidence interval around this proportion (24%) is higher than the 19% found by Heffner and colleagues45 in a study of patients with COPD enrolled in a pulmonary rehabilitation program. The increase likely represents temporal changes, with an increase in emphasis on
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Reproduction of this article is prohibited without written permission from the American College of Chest Physicians (www.chestjournal.org/misc/reprints.shtml).
This project was supported by a Career Investigator Award from the American Lung Association and the American Lung Association of Washington (Dr. Curtis).