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Introduction to caring for the patient with advanced chronic obstructive pulmonary disease Introduction to caring for the patient with advanced chronic obstructive pulmonary disease
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Conventional COPD treatments Conventional COPD treatments
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Inhaled therapy Inhaled therapy
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Systemic therapy Systemic therapy
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Theophyllines Theophyllines
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Phosphodiesterase 4 (PDE4) inhibitors Phosphodiesterase 4 (PDE4) inhibitors
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Corticosteroids Corticosteroids
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Oxygen therapy Oxygen therapy
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During acute exacerbations of COPD During acute exacerbations of COPD
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Long-term oxygen therapy (LTOT) Long-term oxygen therapy (LTOT)
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Supplemental oxygen for the mildly hypoxaemic patient Supplemental oxygen for the mildly hypoxaemic patient
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Managing acute exacerbations Managing acute exacerbations
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COPD: symptom burden related to dyspnoea COPD: symptom burden related to dyspnoea
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Current approaches to the management of dyspnoea in advanced COPD Current approaches to the management of dyspnoea in advanced COPD
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Neuromuscular electrical stimulation and chest wall vibration Neuromuscular electrical stimulation and chest wall vibration
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Patient self-management education Patient self-management education
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Pulmonary rehabilitation Pulmonary rehabilitation
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Addressing gaps in care through integrated care systems Addressing gaps in care through integrated care systems
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Communication and advance care planning Communication and advance care planning
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Opioid therapy for dyspnoea in COPD Opioid therapy for dyspnoea in COPD
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Conclusions Conclusions
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References References
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15.2 Caring for the patient with advanced chronic obstructive pulmonary disease
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Published:March 2015
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Abstract
The global prevalence of chronic obstructive pulmonary disease (COPD) is high and rising. Patients and families living with advanced disease often experience biopsychosocial symptom burdens over a long trajectory, leaving them housebound when they require support the most. Current models of care, by placing a disproportionate focus on the provision of acute and facility-based services, do little to address the complex needs of those vulnerable patients and families who struggle to easily access primary care services. This chapter provides an overview of conventional COPD treatments and highlights some newer understandings and management approaches for patients living with high symptom burden despite optimized conventional treatments, including the use of opioids. It provides some concrete examples of models of care that employ interventions and holistic approaches to care that can improve patient and family outcomes. The move towards an integrated care approach to COPD will help patients and their families reach informed decisions about their care throughout the trajectory of COPD.
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