Palliative care for patients with severe chronic lung diseases - a Swiss position paper.

Severe chronic lung diseases are frequently associated with a high symptom burden, dependence on caregivers, poor quality of life and a high risk of early mortality. Medical, psychological and social situations can become increasingly complex despite established disease-modifying treatment. In patients with lung cancer, palliative care (PC) is well established; however, PC is typically underused in chronic lung diseases including chronic obstructive pulmonary disease, interstitial lung disease and pulmonary hypertension. With this position paper the multidisciplinary and interprofessional expert group aims to guide health care professionals on how to assess and address PC needs and when to refer patients for specialized PC. Furthermore, to increase awareness and encourage interprofessional education and research on PC in patients with chronic lung diseases. PC is a holistic, multidisciplinary, person-centred approach to control symptoms, and improve quality of life in patients with severe chronic respiratory diseases and to support their caregivers. PC and symptom-oriented treatment should be delivered early alongside with disease-modifying treatment and adapted to individual values and needs of patients and caregivers. General PC can be provided by non-specialists whereas a specialized PC team is needed when symptoms become challenging to treat and care situations become increasingly complex. Patients with severe chronic lung diseases and their caregivers benefit tremendously from PC, which ranges from simple symptom control to complex interventions delivered by multidisciplinary and interprofessional teams. There is still a clear need to improve availability, awareness, education, and research on PC for patients with severe chronic lung diseases.