European Respiratory Society clinical practice guideline: palliative care for people with COPD or interstitial lung disease

There is increased awareness of palliative care needs in people with chronic obstructive pulmonary disease(COPD) or interstitial lung disease (ILD). This European Respiratory Society (ERS) task force aimed to provide recommendations for initiation and integration of palliative care into the respiratory care of adult people with COPD or ILD. The ERS task force consisted of 20 members, including representatives of people with COPD or ILD and informal caregivers. Eight questions were formulated, four in the ‘Population, Intervention, Comparison, Outcome’ (PICO) format. These were addressed with full systematic reviews and application of Grading of Recommendations Assessment, Development and Evaluation (GRADE) for assessing the evidence. Four additional questions were addressed narratively. An ’evidence-to-decision’ framework was used to formulate recommendations. The following definition of palliative care for people with COPD or ILD was agreed: A holistic and multidisciplinary, person-centred approach aiming to control symptoms, and improve quality of life of people with serious health-related suffering because of COPD or ILD, and to support their informal caregivers. Recommendations were made regarding people with COPD or ILD and their informal care givers to: consider palliative care when physical, psychological, social, or existential needs are identified through holistic needs assessment; offer palliative care interventions, including support for informal caregivers, in accordance with such needs; offer advance care planning in accordance with preferences; and integrate palliative care into routine COPD and ILD care. Recommendations should be reconsidered as new evidence becomes available.