TY - JOUR
T1 - Palliative Care Early in the Care Continuum among Patients with Serious Respiratory Illness
T2 - An Official ATS/AAHPM/HPNA/SWHPN Policy Statement
AU - Sullivan, Donald R
AU - Iyer, Anand S
AU - Enguidanos, Susan
AU - Cox, Christopher E
AU - Farquhar, Morag
AU - Janssen, Daisy J A
AU - Lindell, Kathleen O
AU - Mularski, Richard A
AU - Smallwood, Natasha
AU - Turnbull, Alison E
AU - Wilkinson, Anne M
AU - Courtright, Katherine R
AU - Maddocks, Matthew
AU - McPherson, Mary Lynn
AU - Thornton, J Daryl
AU - Campbell, Margaret L
AU - Fasolino, Tracy K
AU - Fogelman, Patricia M
AU - Gershon, Larry
AU - Gershon, Thayer
AU - Hartog, Christiane
AU - Luther, Judy
AU - Meier, Diane E
AU - Nelson, Judith E
AU - Rabinowitz, Elliot
AU - Rushton, Cynda H
AU - Sloan, Danetta H
AU - Kross, Erin K
AU - Reinke, Lynn F
N1 - Funding Information:
Subcommittee Disclosures: D.R.S. received research support from the Sojourns Scholar Leadership Program Award of the Cambia Health Foundation. A.S.I. served as a consultant for AstraZeneca; and received research support from National Institute on Aging and National Institutes of Health. L.F.R. served on a data safety and monitoring board for Hospice & Palliative Nursing Association Board of Directors; served as a speaker for UpToDate; received travel support from University of Utah, College of Nursing, Professional Development Funds; and received research support from Department of Veterans Affairs Health Services. C.E.C. received research and travel support from National Institutes of Health; and served on the data safety and monitoring board for National Institute on Aging. C.H. served as the elected leader of the ethics section of the European Society of Intensive Care Medicine; and received research support from Innovations Fund of the German Federal Joint Committee and European Society of Intensive Care Medicine. D.J.A.J. served as a speaker for Abbott, Boehringer Ingelheim, and Chiesi; served on a data safety and monitoring board for BETTER-B and Wolfson Palliative Care Research Centre Hull U.K.; and received research support from the Netherlands Organization for Health Research and Development and Stichting Astmabestriiding. K.O.L. received research support from U.S. Department of Health and Human Services, National Institutes of Health, and National Institute of Nursing Research; received travel support from the University of Pittsburgh, and Medical University of South Carolina; and holds a patent for A Program of SUPPORTÔ. M.M. received research support from National Institute for Health and Care Research U.K. R.A.M. served as a consultant for eThera; and received research support from and served on an advisory committee for GlaxoSmithKline. E.R. served as a speaker for and received travel support from North American Cystic Fibrosis Conference. N.S. served on the advisory board for Thoracic Society of Australia and New Zealand, and Lung Foundation of Australia; and served as a speaker for Boehringer Ingelheim, GlaxoSmithKline, and Thoracic Society of Australia and New Zealand. J.D.T. served on the data safety and monitoring board for Lift Study; and received research support from National Institutes of Health. A.E.T. served as a consultant for Medical Science Affiliates; and received research support from NHLBI. S.E., M.L.C., K.R.C., M.F., T.K.F., P.M.F., L.G., T.G., E.K.K., J.L., M.L.M., D.E.M., J.E.N., C.H.R., D.H.S., and A.M.W., reported no commercial or relevant noncommercial interests from ineligible companies.
Funding Information:
research support from the Sojourns Scholar Leadership Program Award of the Cambia Health Foundation. A.S.I. served as a consultant for AstraZeneca; and received research support from National Institute on Aging and National Institutes of Health. L.F.R. served on a data safety and monitoring board for Hospice & Palliative Nursing Association Board of Directors; served as a speaker for UpToDate; received travel support from University of Utah, College of Nursing, Professional Development Funds; and received research support from Department of Veterans Affairs Health Services. C.E.C. received research and travel support from National Institutes of Health; and served on the data safety and monitoring board for National Institute on Aging. C.H. served as the elected leader of the ethics section of the European Society of Intensive Care Medicine; and received research support from Innovations Fund of the German Federal Joint Committee and European Society of Intensive Care Medicine. D.J.A.J. served as a speaker for Abbott, Boehringer Ingelheim, and Chiesi; served on a data safety and monitoring board for BETTER-B and Wolfson Palliative Care Research Centre Hull U.K.; and received research support from the Netherlands Organization for Health Research and Development and Stichting Astmabestriiding. K.O.L. received research support from U.S. Department of Health and Human Services, National Institutes of Health, and National Institute of Nursing Research; received travel support from the University of Pittsburgh, and Medical University of South Carolina; and holds a patent for A Program of SUPPORTÔ. M.M. received research support from National Institute for Health and Care Research U.K. R.A.M. served as a consultant for eThera; and received research support from and served on an advisory committee for GlaxoSmithKline. E.R. served as a speaker for and received travel support from North American Cystic Fibrosis Conference. N.S. served on the advisory board for Thoracic Society of Australia and New Zealand, and Lung Foundation of Australia; and served as a speaker for Boehringer Ingelheim, GlaxoSmithKline, and Thoracic Society of Australia and New Zealand. J.D.T. served on the data safety and monitoring board for Lift Study; and received research support from National Institutes of Health. A.E.T. served as a consultant for Medical Science Affiliates; and received research support from NHLBI. S.E., M.L.C., K.R.C., M.F., T.K.F., P.M.F., L.G., T.G., E.K.K., J.L., M.L.M., D.E.M., J.E.N., C.H.R., D.H.S., and A.M.W., reported no commercial or relevant noncommercial interests from ineligible companies.
Publisher Copyright:
Copyright © 2022 by the American Thoracic Society.
PY - 2022/9/15
Y1 - 2022/9/15
N2 - Background: Patients with serious respiratory illness and their caregivers suffer considerable burdens, and palliative care is a fundamental right for anyone who needs it. However, the overwhelming majority of patients do not receive timely palliative care before the end of life, despite robust evidence for improved outcomes. Goals: This policy statement by the American Thoracic Society (ATS) and partnering societies advocates for improved integration of high-quality palliative care early in the care continuum for patients with serious respiratory illness and their caregivers and provides clinicians and policymakers with a framework to accomplish this. Methods: An international and interprofessional expert committee, including patients and caregivers, achieved consensus across a diverse working group representing pulmonary-critical care, palliative care, bioethics, health law and policy, geriatrics, nursing, physiotherapy, social work, pharmacy, patient advocacy, psychology, and sociology. Results: The committee developed fundamental values, principles, and policy recommendations for integrating palliative care in serious respiratory illness care across seven domains: 1) delivery models, 2) comprehensive symptom assessment and management, 3) advance care planning and goals of care discussions, 4) caregiver support, 5) health disparities, 6) mass casualty events and emergency preparedness, and 7) research priorities. The recommendations encourage timely integration of palliative care, promote innovative primary and secondary or specialist palliative care delivery models, and advocate for research and policy initiatives to improve the availability and quality of palliative care for patients and their caregivers. Conclusions: This multisociety policy statement establishes a framework for early palliative care in serious respiratory illness and provides guidance for pulmonary-critical care clinicians and policymakers for its proactive integration.
AB - Background: Patients with serious respiratory illness and their caregivers suffer considerable burdens, and palliative care is a fundamental right for anyone who needs it. However, the overwhelming majority of patients do not receive timely palliative care before the end of life, despite robust evidence for improved outcomes. Goals: This policy statement by the American Thoracic Society (ATS) and partnering societies advocates for improved integration of high-quality palliative care early in the care continuum for patients with serious respiratory illness and their caregivers and provides clinicians and policymakers with a framework to accomplish this. Methods: An international and interprofessional expert committee, including patients and caregivers, achieved consensus across a diverse working group representing pulmonary-critical care, palliative care, bioethics, health law and policy, geriatrics, nursing, physiotherapy, social work, pharmacy, patient advocacy, psychology, and sociology. Results: The committee developed fundamental values, principles, and policy recommendations for integrating palliative care in serious respiratory illness care across seven domains: 1) delivery models, 2) comprehensive symptom assessment and management, 3) advance care planning and goals of care discussions, 4) caregiver support, 5) health disparities, 6) mass casualty events and emergency preparedness, and 7) research priorities. The recommendations encourage timely integration of palliative care, promote innovative primary and secondary or specialist palliative care delivery models, and advocate for research and policy initiatives to improve the availability and quality of palliative care for patients and their caregivers. Conclusions: This multisociety policy statement establishes a framework for early palliative care in serious respiratory illness and provides guidance for pulmonary-critical care clinicians and policymakers for its proactive integration.
KW - Advance Care Planning
KW - Continuity of Patient Care
KW - Humans
KW - Palliative Care
KW - Policy
KW - Societies, Medical
KW - United States
UR - http://www.scopus.com/inward/record.url?scp=85138136190&partnerID=8YFLogxK
U2 - 10.1164/rccm.202207-1262ST
DO - 10.1164/rccm.202207-1262ST
M3 - Article
C2 - 36112774
SN - 1073-449X
VL - 206
SP - e44-e69
JO - American Journal of Respiratory and Critical Care Medicine
JF - American Journal of Respiratory and Critical Care Medicine
IS - 6
ER -
