European Respiratory Society clinical practice guideline: palliative care for people with COPD or interstitial lung disease.

There is increased awareness of palliative care needs in people with COPD or interstitial lung disease (ILD). This European Respiratory Society (ERS) task force aimed to provide recommendations for initiation and integration of palliative care into the respiratory care of adult people with COPD or ILD. The ERS task force consisted of 20 members, including representatives of people with COPD or ILD and informal caregivers. Eight questions were formulated, four in the Population, Intervention, Comparison, Outcome format. These were addressed with full systematic reviews and application of Grading of Recommendations Assessment, Development and Evaluation for assessing the evidence. Four additional questions were addressed narratively. An "evidence-to-decision" framework was used to formulate recommendations. The following definition of palliative care for people with COPD or ILD was agreed. A holistic and multidisciplinary person-centred approach aiming to control symptoms and improve quality of life of people with serious health-related suffering because of COPD or ILD, and to support their informal caregivers. Recommendations were made regarding people with COPD or ILD and their informal caregivers: to consider palliative care when physical, psychological, social or existential needs are identified through holistic needs assessment; to offer palliative care interventions, including support for informal caregivers, in accordance with such needs; to offer advance care planning in accordance with preferences; and to integrate palliative care into routine COPD and ILD care. Recommendations should be reconsidered as new evidence becomes available.
Competing Interests: Conflict of interest: D.J.A. Janssen reports lecture fees from Boehringer Ingelheim (personal), Chiesi (non-personal), AstraZeneca (non-personal) and Abbott (non-personal) within the previous three years outside the submitted work. Conflict of interest: C. Coleman is an employee of the European Lung Foundation. Conflict of interest: D.C. Currow has received intellectual property payments and consultancy fees from Mayne Pharma International Pty Ltd, manufacturers of Kapanol and is a paid adviser to Helsinn Pharmaceuticals. Conflict of interest: G.P. Kurita has received grants from Novo Nordisk Foundation, the Danish Cancer Society and European Commission outside the submitted work. Conflict of interest: M. Maddocks is supported by the National Institute for Health and Care Research (NIHR) Applied Research Collaboration South London (NIHR ARC South London) at King's College Hospital NHS Foundation Trust; the views expressed are those of the author(s) and not necessarily those of the NIHR or the Department of Health and Social Care. Conflict of interest: H. Pinnock has received speaker fees from Boehringer Ingelheim, Teva, and Sandoz for non-promotional talks on digital respiratory health and asthma supported selfmanagement. Conflict of interest: T. Tonia is a methodologist for the European Respiratory Society. Conflict of interest: K. Marsaa reports lecture fees from Astellas Pharma, GlaxoSmithKline, AstraZeneca, Novartis, Boehringer Ingelheim, Kyowa Kirin, Norgine, Roche, Bristol-Myers Squibb, Chiesi Pharma outside the submitted work. Conflict of interest: All other panellists have no conflicts of interest to report.
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