Mitigating the impact of breathlessness in Chronic Obstructive Pulmonary Disease: can a structured specialty palliative care intervention fill in the gap in our treatment algorithms?

Breathlessness is a distressing symptom, uniformly faced at some point in the disease process all patients with Chronic Obstructive Pulmonary Disease (COPD). Despite maximal medical therapy and pulmonary rehabilitation, COPD continue to experience refractory dyspnea, pain, poor appetite, limitations of physical activity, emotional distress, depression overall health-related quality life. Our current GOLD ABE pharmacologic treatment algorithm provides specific directed optimization physiologic airflow obstruction exacerbation frequency, however leaving gap how best approach complex multifactorial symptom breathlessness that occurs despite these interventions rehabilitation. The comprehensive multidisciplinary specialty palliative care may well fill this our algorithms. In review, we will review growing body literature on definitions role primary COPD, components structured intervention advanced lung disease, non-pharmacologic treatments for breathlessness, identified barriers consider future direction engagement COPD.