Pulmonary Disease: Prognosis-Based, Symptoms-Based or Needs-Based? REVIEW Palliative Care Initiation in Chronic Obstructive

The barriers in offering timely integrated PC services to COPD patients are complex. Despite the identification of validated prognostic variables and multidimensional indices, none of them are sufficiently reliable to predict survival and implicit the moment to start PC in COPD patients. The decision to initiate PC should be rather based on the presence of refractory chronic symptoms and patients’ unmet needs and preferences. Despite the current advances, the ideal model to initiate longitudinal palliative care from the moment COPD is diagnosed, alongside the usual management of the disease and intensified care in the end-of-life stages, is a goal for clinicians trained in and capable of providing palliative care in any COPD patient.