New models of care for advanced lung disease

Abstract

Chronic lung disease is growing in prevalence and patients are living longer with long-term illness and a high-symptom burden: as these diseases are so common there are now millions of affected individuals and their families living with the sequelae worldwide. This has profound effects on the individual concerned (who is often highly symptomatic with breathlessness), their family, and on health services. There is a growing recognition that the historical model of medical management aimed at the disease alone is not meeting patients' needs and leading to high levels of unscheduled use of medical services at high financial cost and without health gain leading to further frustration for the patient. Service models for palliative care aimed at patients with a rapid deterioration from good health to death can also fail to meet the needs of this group. This paper examines new models of care for patients with advanced lung disease, outlining three services in some detail with a brief review of available evidence. It calls for new ways of evaluating the impact of such services.

Keywords:

• Chronicity
• Breathlessness
• Service
• Model
• Carer
• Innovation
• Palliative care