Consensus Document on the Multidisciplinary Management of Advanced-Stage Respiratory Diseases

Advanced respiratory diseases, particularly chronic obstructive pulmonary disease (COPD) and interstitial lung diseases (ILD), constitute an increasing challenge for healthcare systems due to their high prevalence, substantial symptom burden, and significant resource use. This consensus document, developed jointly by the Spanish Society of Pulmonology and Thoracic Surgery (SEPAR) and the Spanish Society of Palliative Care (SECPAL), provides recommendations for a multidisciplinary, integrated model of care. Using the SIGN methodology and a systematic literature review, a multidisciplinary panel developed 70 evidence-based recommendations addressing key domains: identification of patients with palliative care needs; management of respiratory symptoms; strategies to improve quality of life; communication and shared decision-making; caregiver support; and coordination across care settings. A needs-based approach, rather than reliance on prognosis alone, is recommended to facilitate earlier recognition of patients with advanced COPD and ILD and to enable the timely integration of palliative care alongside disease-directed therapies. Adoption of these recommendations is expected to improve quality of life, reduce symptom burden and suffering, and optimize care for patients with advanced respiratory diseases.