Characterizing Episodic Breathlessness in Patients with Advanced Disease
Publication: Journal of Palliative Medicine
Volume 16, Issue Number 10
Abstract
Background: Episodic breathlessness is a common and distressing symptom in advanced cancer and nonmalignant diseases but there is a lack of evidence on the characteristics of the symptom.
Objective: The aim of this study was to determine the duration, severity, frequency and timing of breathlessness episodes in patients with advanced diseases.
Methods: Explorative analysis of pooled cross-sectional data on episodic breathlessness collected in personal interviews with patients suffering from chronic obstructive pulmonary disease, lung cancer, chronic heart failure, or motor neuron disease. Interviews were conducted as part of two studies in the UK and in Germany that included the same questions on duration, frequency, timing, and peak severity of breathlessness episodes. Severity was measured on the modified Borg scale (0–10).
Results: One hundred and twenty-nine patients, 61% male, mean age of 67 years (SD 9.8), were included. The episodes described were mainly short (75%≤10 min), severe (mean 6.5 (SD 2.4), and occurred mostly daily. Frequency of episodes triggered by exertion could hardly be determined as these varied depending on patients' activity.
Conclusion: Our study reveals clinically important information on the characteristics of episodic breathlessness in patients with advanced diseases. Findings have implications for the treatment of episodic breathlessness since most short-acting drugs in use have a longer onset of action compared to the duration of episodes. We need to determine patient-relevant therapeutic targets for future evaluation of adequate pharmacological and nonpharmacological management options that are urgently warranted.
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Information & Authors
Information
Published In
Journal of Palliative Medicine
Volume 16 • Issue Number 10 • October 2013
Pages: 1275 - 1279
PubMed: 24053592
Copyright
Copyright 2013, Mary Ann Liebert, Inc.
History
Published online: 7 October 2013
Published in print: October 2013
Published ahead of print: 20 September 2013
Accepted: 20 May 2012
Authors
Author Disclosure Statement
This study was presented as a poster presentation in 2012 at the 9th Congress of the German Association for Palliative Medicine, Berlin, Germany.
Steffen Simon and Rau Voltz received research funding for a clinical trial from TEVA Ltd., after this study was conducted. All of the other authors declare that no conflicting financial interests exist.
Funding
This study was supported by a research grant from the Dr. Werner Jackstädt Foundation, Wuppertal, Germany, the Cicely Saunders Institute, King's College London, London, United Kingdom, and the German Federal Ministry of Research of Education and Research (grant number BMBF 16KT0951) without any influence on study design, analysis, interpretation, or presentation.
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