Factors associated with awareness of palliative care among patients with chronic obstructive pulmonary disease

INTRODUCTION Chronic obstructive pulmonary disease (COPD) leads to respiratory morbidities and mortalities. Despite its importance in alleviating respiratory consequences, palliative services and awareness in COPD patients worldwide is currently limited. The objectives of this study were to measure the prevalence of COPD patients with an awareness that palliative care (PC) is part of COPD care, and to evaluate factors associated with patients' PC awareness.METHODS A cross-sectional study was conducted on COPD patients visiting 2 tertiary hospitals from July to December 2018. A questionnaire containing demographic factors, the severity of COPD, and questions on PC perceptions was developed. Patients who met the inclusion criteria were recruited. Factors associated with PC awareness were assessed by multivariate logistic regression analysis.RESULTS A total of 280 patients were recruited (91.1% male) with median age of 73 years (IQR: 65-78), median FEV1% predicted was 62 (IQR: 47- 80), and 22.6% were aware of PC. Only 19 patients (6.8%) were advised by their doctor about advanced care planning (ACP). Factors associated with PC awareness were: age (p=0.014), mMRC score (p=0.01), knowing the term PC (p<0.001), knowing the term CPR (p=0.004), having an ACP (p=0.049), knowing the term 'living will' (p<0.001) and having had discussions with their healthcare providers on PC issues (p=0.037). Multivariate regression analysis showed that the only factor associated with PC awareness was a lower mMRC score (AOR=0.67; 95% CI: 0.51-0.87).CONCLUSIONS PC awareness in COPD patients was low. Discussions on PC issues between healthcare providers and patients were not widespread. Suggestions for policy implications and future research are needed.