Murray Scott A, Pinnock Hilary, Sheikh Aziz
Division of Community Health Sciences: GP Section, University of Edinburgh, 20, West Richmond St, Edinburgh, UK.
Prim Care Respir J. 2006 Dec;15(6):362-4. doi: 10.1016/j.pcrj.2006.08.008. Epub 2006 Oct 24.
The need to extend the palliative care approach to people dying with a wide range of chronic diseases is increasingly recognised. Whilst of relevance internationally, this topic is particularly timely in the UK as the General Medical Services contract will reward practices that create a register of patients "in need of palliative/supportive care". Difficulty predicting prognosis can lead to uncertainty about which patients with COPD to include in a register, potentially reducing the impact of this initiative. In this Discussion paper we highlight this challenge, and offer some practical strategies to help clinicians recognise these patients.
将姑息治疗方法扩展至患有各种慢性疾病的临终患者的需求日益得到认可。尽管这一话题在国际上具有相关性，但在英国尤为适时，因为全科医疗服务合同将奖励那些创建“需要姑息/支持性护理”患者登记册的医疗机构。难以预测预后可能导致在确定哪些慢性阻塞性肺疾病（COPD）患者应纳入登记册时存在不确定性，这可能会降低该举措的影响力。在本讨论文件中，我们强调了这一挑战，并提供了一些实用策略，以帮助临床医生识别这些患者。
