A qualitative study of unmet healthcare needs in chronic obstructive pulmonary disease: A potential role for specialist palliative care?

Clara J. Schroedl*, Susan E. Yount, Eytan Szmuilowicz, Paul J. Hutchison, Sharon R. Rosenberg, Ravi Kalhan

*Corresponding author for this work

Research output: Contribution to journalArticlepeer-review

42 Scopus citations


Rationale: Patients with chronic obstructive pulmonary disease (COPD) have high symptom burdens and poor health-related quality of life. The American Thoracic Society issued a consensus statement outlining the need for palliative care for patients with chronic respiratory diseases. A better understanding of the unmet healthcare needs among patients with COPD may help determine which aspects of palliative care are most beneficial.

Objectives: To identify the unmet healthcare needs of patients with COPD hospitalized for exacerbation using qualitative methods.

Methods: We conducted 20 semistructured interviews of patients admitted for acute exacerbations of COPD focused on patient understanding of diagnosis and prognosis, effect of COPD on daily life and social relationships, symptoms, healthcare needs, and preparation for the end of life. Transcribed interviews were evaluated using thematic analysis.

Measurements and Main Results: Six themes were identified. (1) Understanding of disease: Most participants correctly identified their diagnosis and recognized their symptoms worsening over time. Only half understood their disease severity and prognosis. (2) Symptoms: Breathlessness was universal and severe. (3) Physical limitations: COPD prevented participation in activities. (4) Emotional distress: Depressive symptoms and/or anxiety were present in most participants. (5) Social isolation: Most participants identified social limitations and felt confined to their homes. (6) Concerns about the future: Half of participants expressed fear about their future.

Conclusions: There are many unmet healthcare needs among patients hospitalized for COPD exacerbation. Relief of symptoms, physical limitations, emotional distress, social isolation, and concerns about the future may be better managed by integrating specialist palliative care into our current care model.

Original languageEnglish (US)
Pages (from-to)1433-1438
Number of pages6
JournalAnnals of the American Thoracic Society
Issue number9
StatePublished - Nov 1 2014


  • Chronic obstructive pulmonary disease
  • Dyspnea
  • End of life
  • Quality of life
  • Symptoms

ASJC Scopus subject areas

  • Pulmonary and Respiratory Medicine

Fingerprint Dive into the research topics of 'A qualitative study of unmet healthcare needs in chronic obstructive pulmonary disease: A potential role for specialist palliative care?'. Together they form a unique fingerprint.

Cite this