Table 4.

Proposed Components of an Outpatient Palliative Medicine Intervention for Patients with COPD

1. Standardized referral criteria11,23

2. Standardized symptoms assessment and documentation of disease severity, therapies, and medical comorbidities6,24,25

3. Interventions:

A. Optimization of COPD management (including prescription of home oxygen, pulmonary rehabilitation)26

B. Prescription of antidepressants and anxiolytics11,27,28

C. Prescription of opiods29,30

D. Consideration of cognitive-behavioral therapy

E. Provision of home services

F. Advance care planning and end of life preparation11,27,31–37

G. Spiritual care

H. Provision of family support25,38,39

4. Evaluation of program outcomes (e.g., determination of impact on patient reported outcomes and health care utilization)

5. Rigorous study of the above interventions

COPD, chronic obstructive pulmonary disease.