{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,27]],"date-time":"2026-10-27T03:42:48Z","timestamp":1793072568774,"version":"4.5.0"},"reference-count":32,"publisher":"SAGE Publications","license":[{"start":{"date-parts":[[2025,8,1]],"date-time":"2025-08-01T00:00:00Z","timestamp":1754006400000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by-nc\/4.0\/"},{"start":{"date-parts":[[2025,8,1]],"date-time":"2025-08-01T00:00:00Z","timestamp":1754006400000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/journals.sagepub.com\/page\/policies\/text-and-data-mining-license"}],"content-domain":{"domain":["journals.sagepub.com"],"crossmark-restriction":true},"short-container-title":["Ther Adv Respir Dis"],"published-print":{"date-parts":[[2025,8]]},"abstract":"<jats:sec>\n                    <jats:title>Background:<\/jats:title>\n                    <jats:p>Palliative care is essential for managing advanced chronic illnesses (ACI) but remains underused.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Objectives:<\/jats:title>\n                    <jats:p>We aimed to evaluate the prevalence, associations, and outcomes of palliative care utilization (PCU) in patients with ACIs.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Design:<\/jats:title>\n                    <jats:p>A prospective observational questionnaire-based study.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods:<\/jats:title>\n                    <jats:p>\n                      The study included hospitalized patients with severe COPD (\n                      <jats:italic>n<\/jats:italic>\n                      \u2009=\u200953), advanced heart failure (HF;\n                      <jats:italic>n<\/jats:italic>\n                      \u2009=\u200956), or metastatic malignancy (\n                      <jats:italic>n<\/jats:italic>\n                      \u2009=\u200957). Participants were interviewed about their demographics, health status, PCU, and end-of-life decision-making.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results:<\/jats:title>\n                    <jats:p>\n                      A total of 166 subjects were included (median age: 77\u2009years; 41% females), with a 1-year median of 2 hospital admissions. Subjects with COPD and HF had low rates of PCU compared to those with malignancy (6% and 11% vs 39%,\n                      <jats:italic>p<\/jats:italic>\n                      \u2009&lt;\u20090.01). PCU occurred exclusively in patients who had visited a specialist (cardiologist, pulmonologist, or oncologist) before study inclusion. Patients with PCU were more aware of advance directives (71% vs 38%), signed advanced orders (23% vs 3%), and shared their end-of-life decisions with others (71% vs 29%). These differences remained significant after adjustment for prior specialist visits. Independent associations with PCU were self-identifying as non-religious (adjusted OR 3.41, 95% CI 1.2\u20139.9), above high-school education (AOR 2.84, 95% CI 1.1\u20137.3), and chronic pain (aOR 2.81, 95% CI 1.11\u20137.14), while COPD showed the opposite (aOR 0.25, 95% CI 0.07\u20130.96).\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion:<\/jats:title>\n                    <jats:p>Palliative care utilization is alarmingly low among patients with HF and COPD despite significant symptom burden. Specialists should advocate for PCU as their involvement could enhance end-of-life care planning, improve patient outcomes, and address current gaps in care.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1177\/17534666251364056","type":"journal-article","created":{"date-parts":[[2025,8,13]],"date-time":"2025-08-13T01:44:29Z","timestamp":1755049469000},"update-policy":"https:\/\/doi.org\/10.1177\/sage-journals-update-policy","source":"Crossref","is-referenced-by-count":5,"title":["Underutilization of palliative care in advanced COPD and heart failure: associations, disparities, and the role of specialists"],"prefix":"10.1177","volume":"19","author":[{"given":"Lior","family":"Zornitzki","sequence":"first","affiliation":[{"name":"Internal Medicine B, Tel-Aviv Sourasky Medical Center, Tel Aviv, Israel"},{"name":"Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel"},{"name":"Department of Cardiology, Tel-Aviv Sourasky Medical Center, Tel Aviv, Israel"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Neta","family":"Sror","sequence":"additional","affiliation":[{"name":"Internal Medicine B, Tel-Aviv Sourasky Medical Center, Tel Aviv, Israel"},{"name":"Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Amir","family":"Bar-Shai","sequence":"additional","affiliation":[{"name":"Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel"},{"name":"The Institute of Pulmonary Medicine, Tel-Aviv Sourasky Medical Center, Tel Aviv, Israel"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Rotem","family":"Tellem","sequence":"additional","affiliation":[{"name":"Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel"},{"name":"Palliative Care Unit, Tel-Aviv Sourasky Medical Center, Tel Aviv, Israel"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Shmuel","family":"Banai","sequence":"additional","affiliation":[{"name":"Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel"},{"name":"Department of Cardiology, Tel-Aviv Sourasky Medical Center, Tel Aviv, Israel"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Shir","family":"Frydman","sequence":"additional","affiliation":[{"name":"Internal Medicine B, Tel-Aviv Sourasky Medical Center, Tel Aviv, Israel"},{"name":"Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel"},{"name":"Department of Cardiology, Tel-Aviv Sourasky Medical Center, Tel Aviv, Israel"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Gil","family":"Bornstein","sequence":"additional","affiliation":[{"name":"Internal Medicine B, Tel-Aviv Sourasky Medical Center, Tel Aviv, Israel"},{"name":"Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-7272-5284","authenticated-orcid":false,"given":"Ophir","family":"Freund","sequence":"additional","affiliation":[{"name":"Internal Medicine B, Tel-Aviv Sourasky Medical Center, 6 Weizmann Street Tel Aviv 6423906, Tel Aviv, Israel"},{"name":"Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel"},{"name":"The Institute of Pulmonary Medicine, Tel-Aviv Sourasky Medical Center, Tel Aviv, Israel"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"179","published-online":{"date-parts":[[2025,8,12]]},"reference":[{"key":"e_1_3_4_2_2","article-title":"Association between palliative care and healthcare outcomes among adults with terminal non-cancer illness: population based matched cohort study","volume":"370","author":"Quinn KL","year":"2020","unstructured":"Quinn KL, Stukel T, Stall NM, et al. Association between palliative care and healthcare outcomes among adults with terminal non-cancer illness: population based matched cohort study. BMJ 2020; 370: m2257.","journal-title":"BMJ"},{"issue":"4","key":"e_1_3_4_3_2","first-page":"348","article-title":"The role of palliative care at the end of life","volume":"11","author":"Rome RB","year":"2011","unstructured":"Rome RB, Luminais HH, Bourgeois DA, et al. The role of palliative care at the end of life. 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