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Palliative care for adults with nonmalignant chronic lung disease

Lynn F Reinke, PhD, ARNP
Daisy Janssen, MD, PhD
J Randall Curtis, MD, MPH
Section Editors
R Sean Morrison, MD
James K Stoller, MD, MS
Deputy Editors
Helen Hollingsworth, MD
Diane MF Savarese, MD


Palliative care is an interdisciplinary medical specialty that focuses on preventing and relieving suffering and on supporting the best possible quality of life for patients facing serious illness and their families. The primary tenets of palliative care are symptom management; establishing goals of care that are in keeping with the patient’s values and preferences; consistent and sustained communication between the patient and all those involved in his or her care; psychosocial, spiritual, and practical support both to patients and their family caregivers; and coordination across sites of care. Thus, palliative care aims to relieve suffering in all stages of disease and is not limited to end of life care. Palliative services, including setting patient-centered achievable goals for medical care and aggressive symptom management, should be routinely offered alongside curative and disease-modifying treatments for patients with serious illnesses.

Palliative care has been best studied and implemented among patients with cancer, but is also beneficial for patients suffering from chronic lung diseases, such as chronic obstructive pulmonary disease (COPD), interstitial lung disease, pulmonary hypertension, and others. The ultimate goal of palliative care is to improve patients’ quality of life and provide support for patients and their families [1].

Palliative care issues in adult patients with chronic lung disease will be reviewed here. Other aspects of adult palliative care including management of dyspnea and cough, issues related to pediatric palliative care, an overview of patient assessment and symptom management in palliative care, and the palliative care of patients with neuromuscular causes of respiratory failure are discussed separately. (See "Assessment and management of dyspnea in palliative care" and "Palliative care: Overview of cough, stridor, and hemoptysis" and "Pediatric palliative care" and "Approach to symptom assessment in palliative care" and "Overview of comprehensive patient assessment in palliative care" and "Overview of managing common non-pain symptoms in palliative care" and "Palliative care: The last hours and days of life" and "Swallowing disorders and aspiration in palliative care: Definition, consequences, pathophysiology, and etiology" and "Swallowing disorders and aspiration in palliative care: Assessment and strategies for management".)


The disease trajectory of chronic lung diseases, such as chronic obstructive pulmonary disease (COPD) and pulmonary fibrosis, is variable and characterized by considerable uncertainty. While patients typically have a phase of gradual decline, the trajectory can change abruptly due to exacerbations of the underlying lung disease or events caused by a comorbid disease.

The disease trajectories for less common lung diseases such as pulmonary hypertension (PH) or lung transplant recipients differ depending on the cause of the disease, co-morbid conditions, response to treatment or surgery.  

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Literature review current through: Nov 2017. | This topic last updated: Sep 28, 2017.
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