What factors predict severity of palliative care symptoms and concerns in COPD in South Africa? A cross-sectional study.
Greater social support is associated with lower palliative care symptom burden in Chronic Obstructive Pulmonary Disease
What factors predict severity of palliative care symptoms and concerns in COPD in South Africa? A cross-sectional study.
The majority of deaths worldwide are attributable to non-communicable diseases, with approximately four-fifths occurring in low- and middle-income countries.
Our (1) determine the self-reported burden of palliative care-related symptoms and concerns (social, spiritual, psychological, physical), and (2) identify predictors of burdensome symptoms and concerns among adults with Chronic Obstructive Pulmonary Disease attending primary care services in South Africa (including social support).
Completed the African Palliative Care Association African Palliative Outcome Scale (APCA APOS), the Medical Outcomes Study Social Support Survey (Medical Outcomes Study Social Support Survey), the London Chest Activity of Daily Living scale (LCADL), and the Chronic Obstructive Pulmonary Disease Assessment Test (COPD Assessment Test).
more social support linked to lighter symptom burden
In terms of clinical importance APOS items with a prevalence of at least 20% that were rated at the most burdensome levels (scores of 4 or 5) included breathlessness (50.9%), need for help and advice in planning for the future (50.13%), difficulty sharing feelings (29.1%), weakness (25.32%), worry (25.26%), and pain (22.19%).
Reduced ability to perform activities of daily living (LCADL) was associated with worse palliative care outcomes (OR 1.04, 95% CI 1.02-1.07; p <0.001).
Higher (worse) COPD Assessment Test scores were also significantly associated with poorer palliative care outcomes (OR 1.13, 95% CI 1.09-1.17; p <0.001).
The impact of social support on self-report concerns demonstrates the importance of a new public health approach to palliative care for Chronic Obstructive Pulmonary Disease patients attending primary care services in sub-Saharan Africa.