# Healthcare professionals’ representation toward optimal palliative care provision for COPD patients: a cross-sectional survey

## TL;DR

This study explores healthcare professionals' views on providing palliative care for COPD patients in Switzerland, highlighting barriers and potential solutions to improve access.

## Contribution

The study identifies specific barriers and training needs among healthcare professionals in implementing palliative care for COPD patients.

## Key findings

- 47.2% of participants were uncertain about when to refer COPD patients to palliative care.
- 45.5% did not know if local specialized palliative care was available.
- Lack of skills/training was a major barrier to discussing end-of-life care.

## Abstract

Chronic obstructive pulmonary disease (COPD) is a condition causing chronic physical symptoms, psychological burdens, as well as social consequences. This contributes to a major decrease in quality of life (QoL). Palliative care (PC) is a person-centered approach intended to relieve physical, psychological, social, and spiritual suffering. Despite international practice guidelines, patients with COPD have limited access to PC, mostly during end-of-life (EoL) care. It is therefore important to explore healthcare professionals’ (HPs) point of view about PC to improve access for COPD patients to PC.

This study aimed to describe the perceptions of HPs working with COPD patients in Switzerland in different settings on PC provision, implementation, access, and organization. Additionally, we aimed to identify gaps, barriers, training needs, and solutions for HPs related to PC needs.

This is a cross-sectional survey study with quantitative and open-ended questions.

We used an electronic survey sent to HPs working with patients suffering from COPD in the inpatient, outpatient, and home-based settings.

A total of 56 out of 98 participants (57%) answered the questionnaire of which 41.1% were nurses. 47.2% of participants were uncertain about the good timing of addressing COPD patients to PC and did it after several acute exacerbations, during EoL, or at the request of the patient. 45.5% did not know the availability of a local specialized PC. Lack of skills/training was identified as one of the hindering factors to discuss EoL (42.9% N = 56).

Despite recognizing the importance of PC, several barriers were identified, including a lack of knowledge about when to initiate a PC and limited utilization of tools for identifying PC needs. Multidisciplinary teamwork and the identification of a nurse coordinator could improve earlier referrals to PC and improve QoL for COPD patients.