New research shows that establishing a specialty clinic with combined pulmonary and palliative care services for patients with advanced lung disease is an effective way to improve healthcare access for diverse patient populations. The study also showed that the specialty clinic was able to help these patients complete advance care planning.
“Patients with advanced lung disease have high morbidity and mortality in addition to profound symptom burden, with substantial psychological and social distress necessitating symptom management and advance care planning,” wrote the authors, led by Meghan Price. “Palliative care aims to improve quality of life for patients with terminal illnesses through symptom-targeted interventions, managing patient and family expectations, and providing family and caregiver support.”
Their institution opened a Breathlessness Clinic to improve care of patients with significant dyspnea due to advanced lung disease. The goal was to provide symptom management and offer access to palliative care to diverse populations who may have trouble accessing specialty services.
The authors presented some benefits of the model during the CHEST Annual Meeting in Boston, Massachusetts. Their study included 71 patients with interstitial lung disease (ILD) who were seen at the clinic at least once from October 2022 to September 2023. The researchers compared that cohort to 564 patients with ILD who were seen at an ILD clinic from July 2010 to June 2019.
The cohort at the Breathlessness Clinic was 57.7% female, compared with 47.5% at the ILD clinic. Regarding diversity, the Breathlessness Clinic cohort was 57.7% White, 26.6% Black, 11.3% Asian, and 4.2% Hispanic American. At the ILD clinic, the patients were 82.2% White, 9.8% Black, 1.4% Asian, and 0.8% unknown. The researchers emphasized the greater degree of diversity at the Breathlessness Clinic.
Furthermore, patients at the Breathlessness Clinic were significantly more likely to have completed an advance directive or medical orders for life-sustaining treatment compared to those seen at the ILD clinic (49.3% vs 4.2%; P<0.0001 and 42% vs 5%, P<0.0001, respectively).
“Our findings are critical, as previous studies demonstrate that race and ethnicity can impact perception of palliative care experiences, access to palliative care resources, and choices involved in advance care planning,” the authors concluded.
Reference
Price M, Calypso A, Gersten RA. The breathlessness clinic: a multidisciplinary subspeciality palliative care clinic serving traditionally underserved patient populations. Presented at the CHEST Annual Meeting; October 6-9, 2024; Boston, Massachusetts.
