This book provides a thoughtful review of the prevalence, common etiologies, disease trajectories, assessment and treatment of symptoms, pharmacologic and nonpharmacologic interventions and common side effects of chronic obstructive pulmonary disease, heart failure, and renal disease. Communication strategies, caregiving issues, and hospice eligibility are also included.

Upon completion of this self-study program the learner should be better able to

Chronic Obstructive Pulmonary Disease (COPD)

• list the most common etiologies, prevalence, burden, and mortality of COPD
• describe the disease trajectory for patients with COPD
• describe the neurophysiology of dyspnea
• demonstrate the assessment and treatment of COPD and dyspnea, including pharmacologic approaches, oxygen, opioids, and nonpharmacologic approaches
• discuss the indications for noninvasive ventilation (NIV) for patients with end-stage COPD
• refer appropriate patients with COPD to palliative care and hospice
• communicate effectively with patients about end-of-life (EOL) care options for patients with COPD
• describe the impact of anxiety and depression on patients with COPD
• educate patients and families on home care and self-management of COPD.

Heart Failure (HF)

• list HF classifications (New York Heart Association [NYHA] class and American College of Cardiology/American Heart Association [ACC/AHA] staging)
• describe the disease course and illness trajectory in HF
• discuss when to initiate palliative care for HF
• list difficulties in predicting prognosis in HF
• discuss the prognosis for a patient with HF, including the differences in prognosis and therapies for patients with preserved ejection fraction
• describe medical and invasive therapies for HF and how they translate to the palliative care setting
• discuss symptom burden in HF
• describe when it is appropriate to refer patients with HF to hospice.

Renal Disease

• Define the five stages of chronic kidney disease
• Describe three potential disease trajectories for chronic kidney disease
• List common causes of pain in patients with renal failure
• Discuss safe opioid prescribing in renal failure including best practices for opioid selection and dosing
• List common non-pain symptoms in renal failure and treatment options
• Discuss barriers to adequate advance care planning in chronic kidney disease
• Explain how the Medicare hospice benefit applies to patients on dialysis
• Discuss prognostication for patients who discontinue dialysis
• Describe the management of symptoms that commonly occur after dialysis discontinuation

Authors:
Jay Vanston, MD HMDC FAAHPM
Nina O'Connor, MD FAAHPM
Grace Huffman, MD CMD
Niharika Ganta, MD MPH

No CME credits available

Member Price: $65
List Price: $85