TY - JOUR T1 - How long can I go on like this? Dying from cardiorespiratory disease JF - British Journal of General Practice JO - Br J Gen Pract SP - 892 LP - 893 VL - 54 IS - 509 AU - Richard Lehman Y1 - 2004/12/01 UR - http://bjgp.org/content/54/509/892.abstract N2 - ONE of the most important tasks of general practice is to look after patients who are dying. The general practitioner (GP) is usually the one person who can provide continuity and support for patients from the start of their illness to the end, and who tries to ensure that they die without distress and, if possible, in a place of their own choosing.We often achieve this with cancer, but find it much harder to provide a ‘good death’ for patients dying from heart failure or advanced respiratory disease. This issue of the Journal contains two papers that shed light on this important and under-researched area: one of them comes from Leicester in the United Kingdom (UK), and examines the processes of care for patients dying from cardiac and respiratory causes in two general practices;1 the other comes from Auckland, New Zealand, and explores the ways in which a range of GPs perceive themselves as discussing prognosis with patients who have severe chronic obstructive pulmonary disease (COPD).2One of the most striking features of the Leicester study is the similarity between patients dying of cancer and those dying of cardiorespiratory disease. There was no significant difference in age, comorbidity, continuity of care, or the proportion who died at home. We know from other studies that the symptom burden is also similar, including depression, cachexia, fatigue, and generalised pain, in addition to the severe breathlessness that characterises advanced cardiorespiratory disease. Patients with cardiorespiratory disease, therefore, have palliative needs at least as great as those patients with cancer. This … ER -