From the Research
Pulmonary Function Tests (PFTs) are generally not recommended for hospice patients due to the focus on comfort care rather than diagnostic testing in end-of-life care. When considering PFTs in hospice patients, clinicians should first evaluate whether the test results would meaningfully change the patient's treatment plan or improve their quality of life. If PFTs are deemed necessary, they should be performed with minimal discomfort, potentially using simplified protocols such as basic spirometry rather than comprehensive testing, as discussed in 1. The patient should be allowed to remain seated rather than standing, and testing should be stopped if it causes distress. Supplemental oxygen should be available for patients who experience desaturation during testing. The interpretation of results should consider the patient's overall goals of care, with emphasis on symptom management rather than achieving normal values. Medications that might be adjusted based on PFT results include bronchodilators like albuterol or ipratropium, which could be initiated or titrated for symptom relief, as suggested by studies on pulmonary function testing in various contexts, including 2 and 3. The decision to perform PFTs should ultimately be guided by whether the information gained will help manage symptoms like dyspnea or cough, rather than for diagnostic purposes or disease monitoring, aligning with the principles of palliative care, as indicated in 4 and 5. Key considerations include:
- Evaluating the potential impact of PFTs on the patient's treatment plan and quality of life
- Minimizing discomfort and distress during testing
- Focusing on symptom management rather than diagnostic purposes
- Considering the use of simplified testing protocols and supplemental oxygen as needed
- Adjusting medications based on PFT results to alleviate symptoms like dyspnea or cough.