Scheerens C, et al. - Researchers examined the feasibility, acceptability, and preliminary effectiveness of early integrated palliative home care (PHC) for end-stage chronic obstructive pulmonary disease (COPD). They tested a 6-month early integrated PHC pilot randomized controlled trial provided by palliative home care nurses (PHCNs) for end-stage COPD. It comprised five elements: 1) preinclusion COPD support training for PHCNs; 2) monthly PHC visits; 3) leaflets on coping mechanisms; 4) a protocol on symptom management and support, a care plan and an action plan; and 5) combining PHC and usual care via reporting and communication mechanisms. In this trial, 39 of 70 eligible patients (56%) participated (20:19 intervention vs control group). On average 3.4 PHC visits were reported for a patient, mainly for disease insight, symptom management, and care planning. Outcomes support the feasibility and acceptability of this intervention on early integrated PHC for end-stage COPD but it did not yield the expected preliminary effectiveness. They emphasize enhancing coordination of care, more general practitioner involvement, more intensive training for PHCNs in COPD support, and revision of the trial design, for example, of targeted outcomes in line with individual patient goals and care preferences, before proceeding to a phase 3 trial.