COVID-19: guidance on palliative care from a European Respiratory Society international task force

European Respiratory Journal - Tập 56 Số 3 - Trang 2002583 - 2020
Daisy J.A. Janssen1,2, Magnus Ekström3,4, David C. Currow4,5, Miriam J. Johnson5, Matthew Maddocks6, Anita K. Simonds7, Thomy Tonia8, Kristoffer Marsaa9
1Dept of Health Services Research, Care and Public Health Research Institute, Faculty of Health Medicine and Life Sciences, Maastricht University, Maastricht, The Netherlands
2Dept of Research and Development, CIRO, Horn, The Netherlands
3Faculty of Medicine, Dept of Clinical Sciences Lund, Respiratory Medicine and Allergology, Lund University, Lund, Sweden
4IMPACCT, Faculty of Health, University of Technology Sydney, Ultimo, Sydney, Australia
5Wolfson Palliative Care Research Centre, University of Hull, Hull, UK
6Cicely Saunders Institute of Palliative Care, Policy and Rehabilitation, King’s College London, London, UK
7Sleep and Ventilation Unit, Royal Brompton and Harefield NHS Foundation Trust, London, UK
8Institute of Social and Preventive Medicine, University of Bern, Bern, Switzerland
9Palliative Unit, Herlev and Gentofte Hospital, Copenhagen, Denmark

Tóm tắt

BackgroundMany people are dying from coronavirus disease 2019 (COVID-19), but consensus guidance on palliative care in COVID-19 is lacking. This new life-threatening disease has put healthcare systems under pressure, with the increased need of palliative care provided to many patients by clinicians who have limited prior experience in this field. Therefore, we aimed to make consensus recommendations for palliative care for patients with COVID-19 using the Convergence of Opinion on Recommendations and Evidence (CORE) process.MethodsWe invited 90 international experts to complete an online survey including stating their agreement, or not, with 14 potential recommendations. At least 70% agreement on directionality was needed to provide consensus recommendations. If consensus was not achieved on the first round, a second round was conducted.Results68 (75.6%) experts responded in the first round. Most participants were experts in palliative care, respiratory medicine or critical care medicine. In the first round, consensus was achieved on 13 recommendations based upon indirect evidence and clinical experience. In the second round, 58 (85.3%) out of 68 of the first-round experts responded, resulting in consensus for the 14th recommendation.ConclusionThis multi-national task force provides consensus recommendations for palliative care for patients with COVID-19 concerning: advance care planning; (pharmacological) palliative treatment of breathlessness; clinician–patient communication; remote clinician–family communication; palliative care involvement in patients with serious COVID-19; spiritual care; psychosocial care; and bereavement care. Future studies are needed to generate empirical evidence for these recommendations.

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European Respiratory Journal

Tập 56 Số 3

2002583

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