Professor David C Currow, Palliative and Supportive Services, Flinders University, Adelaide, Australia and Professor Claudia Bausewein Director of the Department for Palliative Medicine at Munich University Hospital and Chair in Palliative Medicine at Munich University, Germany, and Professor Miriam J Johnson, Professor of Palliative Medicine, Supportive care, Early Diagnosis and Advanced disease (SEDA) Research Group, Hull York Medical School, University of Hull, UK, explain the background to a new monograph focusing on the role that palliative care can (and should) play in optimising outcomes for patients with respiratory disease.
We’ve all sat at the bedside of someone who was short of breath. We’ve witnessed the palpable distress of relatives as they watch, helplessly, someone they love struggling with breathlessness day after day. Exhausting for the person concerned and devastating to see, severe breathlessness at rest or on minimal exertion – bathing, dressing or preparing a cup of tea – remains poorly managed.
A new monograph from the European Respiratory Society (ERS) has been released – ‘Palliative Care in Respiratory Disease’.
Firstly, this book deals explicitly with respiratory diseases that require palliation and the key issues in addressing each of these conditions. A major focus of the book is the role that palliative care can (and should) play in optimising outcomes for such patients. Many palliative care services have side-stepped people with respiratory diseases – assuming it must be some other clinical team’s problem – and respiratory teams have struggled to identify who and when should be referred for specialist palliative support. This is despite more than 20 years of evidence that the needs of people with end-stage respiratory diseases such as chronic obstructive pulmonary disease, interstitial lung disease or cystic fibrosis are the same or greater than they are for many other diseases, including cancer.
Secondly, the book is a great primer on better understanding breathlessness, its underlying pathophysiology, treatments that can predictably and safely reduce its intensity, and on its impact on patients and their families. So much is being discovered about the central pathways modulating the sensation of breathlessness, opening up new avenues of research to help this disabling symptom. Health services data about the difference that a structured approach to the assessment and symptomatic treatment of breathlessness is outlined. The real challenge is to answer the question of how we take new clinical information and new models of care and deliver this to the patients that we see in daily practice?
Arguably, breathlessness is still where pain was 20 years ago but we can close that gap quickly by applying the evidence available today into practice and, importantly, into our referral pathways in order to ensure that the needs of people with respiratory disease are better met.
This book is an opportunity to start to change our current paradigms – to look at respiratory disease and respiratory symptoms through new eyes, focusing on the rapidly developing evidence base for all aspects related both to respiratory disease and to breathlessness.
Our patients deserve the highest quality and most current evidence to inform their care.
- Bausewein C, Currow DC and Johnson MJ (Eds). (2016). Palliative care in respiratory disease. European Respiratory Society (ERS). The ERS Monograph is available to access online. Individuals can purchase an eBook version, or full online access is available to ERS members or people at subscribing institutions.
- Print copies of the ERS Monographs are available at the ERS bookshop. Discounts are available for ERS members.
- For more information about the ERS Monograph, please email Eddy Baker, Editorial & Library Services Coordinator, European Respiratory Society.
- ERS International Congress 9 to 13 September 2017, Milan, Italy – Abstract submission now open! Please visit our website for details.