Conclusions:
organ failure, COPD
COPD, SECONDARY
We found no evidence that palliative care improves quality of life in patients with COPD. However, it can potentially reduce acute healthcare use. The consequences of the COVID-19 pandemic led to suboptimal implementation and insufficient power, and may have affected some of our findings.
Patients in advanced stages of COPD suffer from high symptom burden, limited physical functioning and low quality of life.In oncological patients, timely initiation of palliative care alongside usual care improves quality of life and reduces healthcare use.
We did not find improvements in quality of life, but saw fewer intensive care admissions and a trend towards fewer hospital admissions in intervention group patients with advanced COPD.Study power was insufficient and not all patients received the intended palliative care intervention elements, possibly hampering reliable measurement of the clinical effectiveness.
Quality of life is a broad construct and may be difficult to target in patients with advanced organ failure; Future studies should consider a more proximal outcome measure, for example, coping with COPD.Lower acute healthcare use reduces healthcare costs and this is a relevant secondary outcome parameter to society as a whole; This finding needs further exploration.