COPD patients are being unnecessarily pricked, probed and prodded in their last days of life – sometimes despite clear documentation that palliation was the goal of care.
A review of COPD patients who died between 2004 and 2016 found patients typically endured seven episodes of venepuncture, nine arterial blood gases and three chest X-rays during their terminal admission.
The research found almost a third of patients (32%) had tests on the day of their death.
Co-author Dr Natasha Smallwood, a respiratory and sleep medicine physician at the Royal Melbourne Hospital, said it was difficult to prevent tests and X-rays when patients were transferred to hospital at such a late stage.
“These patients obviously have severe disease. Many have had previous admissions, they have severely reduced lung function, 50% of them are on oxygen and yet they are transferred to hospital.”
“When patients are admitted and die on the same day I think that reflects we are failing them in the community.”
“This is obviously a group that need better palliative care, who need a better explanation of how we can manage them at home, and need advance care planning.”
Dr Smallwood said communication and time management issues contributed to 12% of patients still having tests in hospital after documentation of a change from active treatment to palliation.