CHEST Guidelines-When-It-Is-Personal

When-It-Is-Personal_chest

Pdf Summary

In the editorial "When It Is Personal: The Universal Need for Palliative Care," Linda S. Efferen addresses the gap in the utilization of palliative care (PC) for patients with serious conditions like end-stage COPD, despite established recommendations for advanced care planning (ACP) and referrals to PC. Although there has been a 4.5-fold increase in PC usage between 2006 and 2012, only 1.7% of eligible patients receive consultations, highlighting a significant discrepancy between recommendations and actual practice. Despite policies in place for over 25 years, barriers to ACP adoption remain persistent.<br /><br />Efferen emphasizes the societal importance of ACP discussions, noting that they alleviate the decision-making burden on surrogate decision-makers and facilitate care in line with individual preferences. She shares a personal story about implementing a Medical Orders for Life-Sustaining Treatment (MOLST) form for her mother, illustrating the challenges faced by families without medical knowledge. Efferen suggests that while healthcare providers are critical in discussing ACP, changing the status quo may require marketing directly to consumers, similar to how medications are advertised.<br /><br />Efferen argues for broader education and the development of guidelines emphasizing individual preferences. She insists that ACP should not only be the responsibility of primary or specialist care providers but should involve a societal approach. The editorial calls for attention to regional, racial, and socioeconomic disparities in access to PC and suggests that ACP discussions become as familiar as any major healthcare intervention, recognizing it as a crucial life event shared by all.<br /><br />In summary, Efferen advocates for increased efforts to integrate ACP and PC into routine healthcare, facing the challenges head-on and addressing existing disparities to ensure that more individuals are informed and engaged in managing their end-of-life care preferences.

Keywords

palliative care

advanced care planning

end-stage COPD

Medical Orders for Life-Sustaining Treatment

healthcare disparities

patient preferences

surrogate decision-makers

healthcare providers

consumer marketing

end-of-life care