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Abstract
Objectives To identify end-of-life preferences of people with advanced chronic obstructive pulmonary disease (COPD) and to compare characteristics between those who wish to discuss the end-of-life and those who do not.
Methods An analysis of the baseline data of a randomised controlled trial was performed including people with COPD GOLD stages III–IV or former quadrant D with modified Medical Research Council questionnaire grade ≥2, after hospital discharge following an exacerbation. Participants were interviewed using the End-of-Life Preferences Interview.
Results A total of 165 individuals (53% men; 68±9 years old; 55% care dependent) were included. Most participants wished to take part in shared decision-making (78%), to be informed about a short life expectancy (82%), to discuss the end-of-life (82%), to have loved ones around at death (87%) and to choose when to die (70%). They also reported accepting opioids (74%). Preferences for who to provide physical care, the place, consciousness and atmosphere at death as well as life-sustaining treatments were heterogeneous. Participants who wanted to discuss the end-of-life had a significantly higher educational level (p=0.030) and worse health status than participants who did not (p=0.007).
Conclusions End-of-life preferences of people with advanced COPD were heterogeneous, however, most wished to discuss it, especially those with higher educational level and worse health status.
Trial registration number NTR3940.
- Chronic obstructive pulmonary disease
- Palliative Care
- End of life care
- Advance Care Planning
Data availability statement
Details regarding the data analysis will be available from the corresponding author on reasonable request. Participants did not provide informed consent to share their data.
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Data availability statement
Details regarding the data analysis will be available from the corresponding author on reasonable request. Participants did not provide informed consent to share their data.
Footnotes
MAM and AJM are joint first authors.
Contributors CHMH, MAS and DJAJ were involved in study concept and design. CHMH was involved in acquisition of data. All authors interpreted the data. MAM and AJLM drafted the manuscript. All authors critically revised the manuscript and approved its final version to be published.
Funding The authors of the primary study (NTR3940) disclosed receipt of support by the Netherlands Lung Foundation, Amersfoort, The Netherlands (Grant number 3.4.12.022).
Competing interests MAM, AJLM, SH-W, CHMH and AM have no conflicts of interest to declare. MAS reports grants and/or fees from Netherlands Lung Foundation Netherlands, Stichting Astma Bestrijding, Boehringer Ingelheim, AstraZeneca, Chiesi, GSK, Sanofi and TEVA, all paid to the institution and all outside the submitted work. DJAJ has received lecture fees from Chiesi, AstraZeneca and Abbott within the previous 3 years, all paid to the institution and all outside the submitted work.
Provenance and peer review Not commissioned; internally peer-reviewed.
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