Managing symptoms and complications associated with chronic respiratory disease in palliative care
Bausewein, Schumacher, 2018Bausewein, Schunk, 2018Maddocks, 2017
Management of symptoms and complications of chronic respiratory disease in patients with palliative care needs is individualised; it focuses on the patient’s subjective assessment rather than objective measures. A pivotal aspect of symptom management is to optimise disease management—see the Respiratory guidelines for management advice of COPD, bronchiectasis and cystic fibrosis, and the Cardiovascular guidelines for management advice of pulmonary arterial hypertension. The approach depends on the potential benefits and burdens of treatment, and the patient’s prognosis, preferences (including preferred care setting) and goals of care—see Principles of symptom management in palliative care.
Patients with advanced chronic respiratory disease can experience a range of symptoms and complications that require assessment and management. A key aspect of improving symptom control is supporting patients to learn self-management strategies that empower them to use pharmacological and nonpharmacological supports. If available, consider multidisciplinary support (eg pulmonary rehabilitation, breathlessness clinics) because these can improve a variety of symptoms including breathlessness, cough, fatigue and functional deterioration. Symptoms of chronic respiratory disease, particularly breathlessness, often lead to other symptoms and conditions, such as: