Management of COPD in End-of-Life Care by Spanish Pulmonologists

Figures & data

Table 1. Characteristics of participants and differences in characteristics of participants regarding years of experience. Results are expressed in absolute values and percentages.

Variable	Total	≤20 years (n = 211)	>20 years (n = 165)	p Value
Age (years)	48.1 ± 12.7	39.1 ± 6.4	55.1 ± 5.3	<0.001
Sex				<0.001
Men	201 (53.2%)	91 (43.1%)	106 (65%)
Women	177 (46.8%)	120 (56.9%)	57 (35%)
Place of work				0.835
University hospital	285 (75%)	154 (73%)	127 (77%)
Private clinic/hospital	11 (2.9%)	7 (3.3%)	4 (2.4%)
Primary care unit	3 (0.8%)	2 (0.9%)	1 (0.6%)
Other type of hospital	81 (21.3%)	48 (22.8%)	33 (20.0%)
Time dedicated to care of end-stage COPD patients				0.812
None	42 (11.2%)	24 (11.5%)	18 (11%)
A small amount	242 (64.5%)	138 (66%)	102 (62.2%)
A considerable amount	79 (21.1%)	41 (19.6%)	38 (23.2%)
Most of my time	12 (3.2%)	6 (2.9%)	6 (3.6%)
Number of papers on end-of-life care read in the last 6 months				0.001
1–2	281 (75.5%)	166 (79.8%)	113 (69.8%)
3–9	75 (20.2%)	40 (19.2%)	35 (21.6%)
>9	16 (4.3%)	2 (1%)	14 (8.6%)
Religious beliefs				0.050
Believer	177 (47.1%)	111 (52.9%)	66 (40.2%)
Nonbeliever	139 (37%)	70 (33.3%)	67 (40.9%)
Don't know/no response	60 (15.9%)	29 (13.8%)	31 (18.9%)

Table 2. Symptom management. Results are expressed in absolute values and percentages.

	Never	Rarely	Sometimes	Often	Always
Dyspnea (using opioids)	15 (4%)	40 (10.7%)	121 (32.4%)	152 (40.8%)	45 (12.1%)
Pain (using opioids)	10 (2.7%)	50 (13.4%)	111 (29.8%)	173 (46.4%)	29 (7.8%)
Anxiety/depression	27 (7.2%)	61(16.4%)	128 (34.3%)	135 (36.2%)	22 (5.9%)

Figure 1. Collaboration between health professionals. Results are expressed as a percentage of the total.

Table 3. Doctor–patient communication: topics discussed. Results are expressed in absolute values and percentages.

How often do they discuss …	Never	Rarely	Sometimes	Often	Always
Disease course	3 (0.8%)	19 (5.1%)	105 (27.9%)	2016 (57.4%)	33 (8.8%)
Life expectancy	6 (1.6%)	46 (12.4%)	156 (41.9%)	148 (39.8%)	16 (4.3%)
The relationship between death and suffering	34 (9.1%)	101 (27.2%)	103 (27.7%)	116 (31.2%)	18 (4.8%)
The patient´s religious beliefs	116 (31.4%)	119 (32.2%)	73 (19.7%)	39 (10.5%)	23 (6.2%)

Table 4. Doctor–patient communication: Decision making. Results are expressed in absolute values and percentages.

	Never	Rarely	Sometimes	Often	Always
How often do you ask your patients to take decisions about…
Mechanical ventilation/intubation?	22 (5.9%)	86 (22.9%)	112 (29.9%)	108 (28.8%)	47 (12.5%)
Cardiopulmonary resuscitation?	55 (14.7%)	103 (27.5%)	112 (29.9%)	76 (20.3%)	28 (7.5%)
Place of death?	98 (26.6%)	145 (39.4%)	70 (19%)	44 (12%)	11 (3%)
How often do you suggest to patients that they make an advance directive?	75 (20%)	145 (38.7%)	97 (25.9%)	50 (13.3%)	8 (2.1%)
How often do you refer patients to hospital care?	23 (6.4%)	87 (24.2%)	155 (43.1%)	89 (24.7%)	6 (1.7%)
How often do you discuss topics related to end-stage COPD with family members/caregivers while excluding patients themselves?	35 (9.5%)	90 (24.4%)	132 (35.8%)	102 (27.6%)	10 (2.7%)
How often do you adjust the information given to patients or their caregivers/family members?	52 (14.4%)	140 (38.8%)	113 (31.3%)	51 (14.1%)	5 (1.4%)
How often do you make decisions regarding end-stage COPD care only with other health professionals without involving patients or their caregivers/family members?	172 (46%)	212 (32.4%)	58 (15.5%)	23 (6.1%)	0 (0%)

Figure 2. Barriers identified by doctors by years of experience (expressed as percentage).