Abstract
Although the prognosis of people with cystic fibrosis continues to improve many still die of respiratory failure in early adulthood, at a median age of 31 years. They are treated in specialist centers by multidisciplinary teams who strive to provide holistic care and support throughout the course of the disease. As the disease progresses patients have a high level of complex symptoms and a high burden of treatment. Palliative care is intertwined with potential lung transplantation, but up to 40% of patients on a transplant waiting list die before donor organs become available. Palliative care is a key component of comprehensive cystic fibrosis care, and this is now often organized in an integrated model of care with specialist palliative care clinicians forming part of the multidisciplinary team such that palliative care runs in parallel with standard care.
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References
Cystic Fibrosis Trust. UK CF registry annual data report 2017. London: Cystic Fibrosis Trust; 2018. https://www.cysticfibrosis.org.uk/news/registry-report-2017
Cystic Fibrosis Foundation. Patient registry annual data report 2017. Bethesda: Cystic Fibrosis Foundation; 2017. https://www.cff.org/Research/Researcher-Resources/Patient-Registry/2017-Patient-Registry-Annual-Data-Report.pdf
Keogh RH, Szczesniak R, Taylor-Robinson D, Bilton D. Up-to-date and projected estimates of survival for people with cystic fibrosis using baseline characteristics: a longitudinal study using UK patient registry data. J Cyst Fibros. 2018;17:218–27.
Sands D, Repetto T, Dupont LJ, Korzeniewska-Eksterowicz A, Catastini P, Madge S. End of life care for patients with cystic fibrosis. J Cystic Fibros. 2011;10:S37–44.
Gentzsch M, Mall MA. Ion channel modulators in cystic fibrosis. Chest. 2018;154:383–93.
Davies JC, Moskowitz SM, Brown C, et al. Vx-659-Tezacaftor-Ivacaftor in patients with cystic fibrosis and one or two Phe508del alleles. N Engl J Med. 2018;379:1599–611.
Smyth AR, Bell SC, Bojcin S, et al. European cystic fibrosis standards of care: best practice guidelines. J Cyst Fibros. 2014;13:S23–42.
Snell G, Reed A, Stern M, Hadjiliadis D. The evolution of lung transplantation for cystic fibrosis: a 2017 update. J Cyst Fibros. 2017;16:553–64.
Kerem E, Reisman J, Corey M, Canny GJ, Levison H. Prediction of mortality in patients with cystic fibrosis. N Engl J Med. 1992;326:1187–91.
McCarthy C, Dimitrov BD, Meurling IJ, Gunaratnam C, McElvaney NG. The CF-ABLE score: a novel clinical prediction rule for prognosis in patients with cystic fibrosis. Chest. 2013;143:1358–64.
Colman RE, Curtis JR, Nelson JE, et al. Barriers to optimal palliative care of lung transplant candidates. Chest. 2013;143:736–43.
Dellon EP, Sawicki GS, Shores MD, Wolfe J, Hanson LC. Physician practices for communicating with patients with cystic fibrosis about use of non-invasive and invasive mechanical ventilation. Chest. 2012;141:1010–7.
Fuehner T, Kuehn C, Welte T, Gottlieb J. ICU care before and after lung transplantation. Chest. 2016;150:442–50.
Meachery G, DeSoyza A, Nicholson A, et al. Outcomes of lung transplantation for cystic fibrosis in a large UK cohort. Thorax. 2008;63:725–31.
Bourke SJ, Doe SJ, Gascoigne AD, et al. An integrated model of provision of palliative care to patients with cystic fibrosis. Palliat Med. 2009;23:512–7.
Dellon EP, Leigh MW, Yankaskas JR, Noah TL. Effects of lung transplantation on inpatient end of life care in cystic fibrosis. J Cyst Fibros. 2007;6:396–402.
McKenna M, Clark SC. Palliative care in cardiopulmonary transplantation. BMJ Support Palliat Care. 2015;5:427–34.
Bourke SJ, Booth Z, Doe S, et al. A service evaluation of an integrated model of palliative care of cystic fibrosis. Palliat Med. 2016;(7):698–702.
Friedman D, Linnemann RW, Altstein L, et al. The CF-CARES primary palliative care model: a CF-specific structured assessment of symptoms, distress, and coping. J Cyst Fibros. 2018;17:71–7.
Chen E, Killeen KM, Peterson SJ, Saulitis AK, Balk RA. Evaluation of pain, dyspnea, and goals of care among adults with cystic fibrosis: a comprehensive palliative care survey. Am J Hosp Palliat Care. 2017;34:347–52.
Havermans T, Colpaert K, De Boeck K, Dupont L, Abott J. Pain in CF: review of the literature. J Cyst Fibros. 2013;12:423–30.
Ravilly S, Robinson W, Suresh S, Wohl ME, Berde CB. Chronic pain in cystic fibrosis. Pediatrics. 1996;98:741–7.
Nap-van der Vlist MM, Burghard M, Hulzebos HJ, et al. Prevalence of severe fatigue among adults with cystic fibrosis: a single center study. J Cyst Fibros. 2018;17:368–74.
Dellon EP, Shores MD, Nelson KI, Wolfe J, Noah TL, Hanson LC. Family caregiver perspectives on symptoms and treatments for patients dying from complications of cystic fibrosis. J Pain Symptom Manag. 2010;40:829–37.
Havermans T, Colpaert K, Dupont LJ. Quality of life in patients with cystic fibrosis: association with anxiety and depression. J Cyst Fibros. 2008;7:581–4.
Quittner AL, Modi AC, Wainwright C, Otto K, Kirihara J, Montgomery AB. Determination of the minimal clinically important difference scores for the cystic fibrosis questionnaire-revised respiratory symptom scale in two populations of patients with cystic fibrosis and chronic Pseudomonas aeruginosa airway infection. Chest. 2009;135:1610–8.
Heslop K. Cognitive behavioural therapy in cystic fibrosis. J Roy Soc Med. 2006;99:27–9.
Lee A, Holdsworth M, Holland A, Button B. The immediate effect of musculoskeletal physiotherapy techniques and massage on pain and ease of breathing in adults with cystic fibrosis. J Cyst Fibros. 2009;8:79–81.
Sawicki GS, Sellers DE, Robinson WM. High treatment burden in adults with cystic fibrosis: challenges to disease self-management. J Cyst Fibros. 2009;8:91–6.
Pisaturo M, Deppen A, Rochat I, Robinson WM, Hafen GM. Death after cessation of treatment by cystic fibrosis patients: an international survey of clinicians. Palliat Med. 2017;31:82–8.
Goggin J, Cohen RI. CF healthcare workers feel unprepared in providing suitable end of life care and desire more education: results of a nationwide survey. J Cyst Fibros. 2016;15:85–9.
Dellon EP, Helms SW, Hailey CE, et al. Exploring knowledge and perceptions of palliative care to inform integration of palliative care education into cystic fibrosis care. Pediatr Pulmonol. 2018;53:1218–24.
Linnemann RW, O’Malley PJ, Friedman D, et al. Development and evaluation of a palliative care curriculum for cystic fibrosis healthcare providers. J Cyst Fibros. 2016;15:90–5.
Dellon EP, Chen E, Goggin J, et al. Advance care planning in cystic fibrosis: current practices, challenges, and opportunities. J Cyst Fibros. 2016;15:96–101.
Cystic Fibrosis Trust, London. Advance care planning for people with cystic fibrosis. https://www.cysticfibrosis.org.uk/~/media/.../care/.../advance-care-plan-form-v2.ashx.
Linnemann RW, Friedman D, Altstein LL, et al. Advance care planning experiences and preferences among people with cystic fibrosis. J Pall Med. 2018;22:138–44.
Braithwaite M, Philip J, Tranberg H, et al. End of life care in CF: patients, families and staff experience and unmet needs. J Cyst Fibros. 2011;10:253–7.
Dellon EP, Goggin J, Chen E, et al. Defining palliative care in cystic fibrosis: a Delphi study. J Cyst Fibros. 2018;17:416–21.
Cystic Fibrosis Trust. London. End of life planning: things to think about. Cysticfibrosis.org.uk.
American Thoracic Society. Palliative care for people with respiratory disease or critical illness. Am J Respir Crit Care Med. 2018;197:17–8.
Chen E, Homa K, Goggin J, et al. End of life practice patterns at US adult cystic fibrosis care centers: a national retrospective chart review. J Cyst Fibros. 2018;17:548–54.
Mitchell I, Nakielna E, Tullis E, Adair C. Cystic fibrosis: end stage care in Canada. Chest. 2000;118:80–4.
Philip JA, Gold M, Sutherland S, et al. End of life care in adults with cystic fibrosis. J Palliat Med. 2008;11:198–203.
Clisby N, Shaw S, Cormack M. Psychological impact of working with patients with cystic fibrosis at end of life, pre-transplant stage. Palliat and Supportive Care. 2013;11:111–21.
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Bourke, S.J., Quibell, R. (2019). Cystic Fibrosis. In: Bourke, S., Peel, T. (eds) Integrated Palliative Care of Respiratory Disease. Springer, Cham. https://doi.org/10.1007/978-3-030-18944-0_10
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