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Review
. 2025 Jul 14;13(14):1687.
doi: 10.3390/healthcare13141687.

Transforming Palliative Care for Rural Patients with COPD Through Nurse-Led Models

Kristen Poston  1 , Alexa Nasti  1 , Carrie Cormack  1 , Sarah N Miller  1 , Kathleen Oare Lindell  1
Affiliations
Review

Transforming Palliative Care for Rural Patients with COPD Through Nurse-Led Models

Kristen Poston et al. Healthcare (Basel). .

Abstract

Background/Objectives: Chronic obstructive pulmonary disease (COPD) is a leading cause of morbidity and mortality worldwide, with rural populations experiencing higher prevalence and worse outcomes. This paper explores the transformative potential of nurse-led palliative care models in addressing the unique challenges faced by rural patients with COPD and their informal caregivers and synthesizes current evidence on nurse-led palliative care interventions, highlighting their impact on symptom management, advance care planning, and psychosocial support. Methods: This is a comprehensive synthesis of nurse-led palliative care programs, focusing on home-based care, telehealth, community outreach, and primary care integration. Results: Nurse-led interventions significantly improve patient satisfaction, reduce symptom burden, and enhance the likelihood of advance care planning discussions. Home-based care models and telehealth are particularly effective in rural settings, offering accessible and continuous support. Conclusions: Nurses have a critical role in bridging the palliative care gap for rural patients with COPD and their informal caregivers. Expanding nurse-led palliative care services can improve quality of life, reduce healthcare utilization, and promote health equity. Future research should focus on long-term outcomes, cost-effectiveness, and strategies for scaling nurse-led palliative care programs in rural contexts.

Keywords: chronic obstructive pulmonary disease (COPD); education; nurse-led; palliative care; rural.

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Conflict of interest statement

Sarah Miller, Consultant—AstraZeneca. Kathleen Lindell, Consultant—Boehringer-Ingelheim. The remaining authors declare no conflicts of interest.

Figures

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Figure 1
Visual overview of the selection process.
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References

    1. Iyer A.S., Sullivan D.R., Lindell K.O., Reinke L.F. The Role of Palliative Care in COPD. Chest. 2022;161:1250–1262. doi: 10.1016/j.chest.2021.10.032. - DOI - PMC - PubMed
    1. Raju S., Brigham E.P., Paulin L.M., Putcha N., Balasubramanian A., Hansel N.H., McCormack M.C. The Burden of Rural Chronic Obstructive Pulmonary Disease: Analyses from the National Health and Nutrition Examination Survey. Am. J. Respir. Crit. Care Med. 2020;201:488–491. doi: 10.1164/rccm.201906-1128LE. - DOI - PMC - PubMed
    1. Picazo F., Duan K.I., Wai T.H., Hayes S., Leonhard A.G., Fonseca G.A., Plumley R., Beaver K.A., Donovan L.M., Au D.H., et al. Rural Residence Associated with Receipt of Recommended Postdischarge Chronic Obstructive Pulmonary Disease Care among a Cohort of U.S. Veterans. Ann. Am. Thorac. Soc. 2025;22:515–522. doi: 10.1513/AnnalsATS.202405-493OC. - DOI - PubMed
    1. Miller S., Higgins E., Cain J., Coyne P., Peacock R., Logan A., Fasolino T., Lindell K. Dyspnea and Palliative Care in Advanced COPD: A Rapid Review. J. Hosp. Palliat. Nurs. 2024;26:195–204. doi: 10.1097/NJH.0000000000001042. - DOI - PubMed
    1. Miller S. Caring for the Chronically Ill Patient: Understanding How Fear Leads to Activity Avoidance in Individuals with Chronic Respiratory Disease. Int. J. Nurs. 2014;3:11–16.

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