Abstract
Context
Providing palliative care to patients with chronic obstructive pulmonary disease (COPD)
is a priority. Spirometry demonstrating airflow limitation is a diagnostic test for
COPD and a common inclusion criterion for palliative care research. However, there
are barriers to spirometry, and requiring spirometry with airflow limitation may exclude
appropriate patients unable to complete spirometry, or patients with preserved-ratio
impaired spirometry and symptoms or imaging consistent with COPD.
Objectives
To determine differences in quality of life (QOL) and symptoms between patients with
COPD identified based on International Classification of Diseases (ICD) codes and
spirometry with airflow limitation compared to ICD codes only.
Methods
Patients with COPD enrolled in a palliative care trial were included. Patients were
at high risk of hospitalization and death and reported poor QOL. Baseline measures
of QOL (Functional Assessment of Cancer Therapy–General (FACT-G), the Clinical COPD
Questionnaire, and Quality of Life at the End of Life), and symptoms (Patient Health
Questionnaire-8, Generalized Anxiety Disorder-7, fatigue, Insomnia Severity Index)
were compared.
Results
208 patients with COPD were predominantly male, white, and average age was 68.4. Between
patients with ICD codes and spirometry with airflow limitation compared to patients
with ICD codes only, there were no significant differences in FACT-G (59.0 v. 55.0,
p=0.33), other measures of QOL, or symptoms between groups.
Conclusion
These results imply that spirometry may not need to be a requirement for inclusion
into palliative care research or clinical care for patients with poor quality of life
and at high risk for adverse outcomes.
Keywords
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Article Info
Publication History
Accepted:
November 14,
2022
Publication stage
In Press Journal Pre-ProofIdentification
Copyright
© 2022 Published by Elsevier Inc. on behalf of American Academy of Hospice and Palliative Medicine.
