End-stage chronic obstructive pulmonary disease (COPD) presents health care providers with challenges of providing optimal palliative care for patients who follow a less predictable trajectory. The objectives of this study were to evaluate medications being prescribed to patients with end-stage COPD, compared to recommendations made by the Global Initiative for Chronic Obstructive Lung Disease (GOLD) guidelines, and to determine which medications were provided by the hospice organization.

We retrospectively reviewed our database for medications pertaining to COPD management as stated in the GOLD criteria or those used for symptoms associated with end of life.

A total of 745 patients met inclusion criteria, and approximately 63% were prescribed opioids. Prescribing rates for oxygen, short-acting β₂-agonists, and short-acting anticholinergics were 37%, 33%, and 31%, respectively. Systemic and inhaled corticosteroids were prescribed at higher rates of 20% and 18% compared to long-acting bronchodilators.

Medications used for COPD exacerbation management were prescribed at higher rate than those used for maintenance treatment.