Towards an expert consensus to delineate a clinical syndrome of chronic breathlessness
Miriam J. Johnson,Janelle Yorke,John Hansen-Flaschen,Robert W. Lansing,Magnus Ekström,Thomas Similowski,David C. Currow,David C. Currow +7 more
TLDR
Criteria for chronic breathlessness syndrome is proposed and an important first step to address the therapeutic nihilism that has pervaded this neglected symptom and could empower patients and caregivers, improve clinical care, focus research, and encourage wider uptake of available and emerging evidence-based interventions.Abstract:
Breathlessness that persists despite treatment for the underlying conditions is debilitating Identifying this discrete entity as a clinical syndrome should raise awareness amongst patients, clinicians, service providers, researchers and research fundersUsing the Delphi method, questions and statements were generated via expert group consultations and one-to-one interviews (n=17) These were subsequently circulated in three survey rounds (n=34, n=25, n=31) to an extended international group from various settings (clinical and laboratory; hospital, hospice and community) and working within the basic sciences and clinical specialties The a priori target agreement for each question was 70% Findings were discussed at a multinational workshopThe agreed term, chronic breathlessness syndrome, was defined as breathlessness that persists despite optimal treatment of the underlying pathophysiology and that results in disability A stated duration was not needed for "chronic" Key terms for French and German translation were also discussed and the need for further consensus recognised, especially with regard to cultural and linguistic interpretationWe propose criteria for chronic breathlessness syndrome Recognition is an important first step to address the therapeutic nihilism that has pervaded this neglected symptom and could empower patients and caregivers, improve clinical care, focus research, and encourage wider uptake of available and emerging evidence-based interventionsread more
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Journal ArticleDOI
Living with breathlessness: a systematic literature review and qualitative synthesis.
TL;DR: The degree of breathing space is influenced by interaction between the patient's coping style, their help-seeking behaviour and their clinician's responsiveness to breathlessness itself, in addition to managing the underlying disease.
Journal ArticleDOI
Palliative Care for people living with heart failure - European Association for Palliative Care Task Force expert position statement.
Piotr Sobański,Bernd Alt-Epping,David C. Currow,Sarah J. Goodlin,Tomasz Grodzicki,Karen Hogg,Daisy J.A. Janssen,Miriam J. Johnson,Małgorzata Krajnik,Carlo Leget,Manuel Martínez-Sellés,Matteo Moroni,Paul S. Mueller,Mary Ryder,Steffen T. Simon,Emily Stowe,Philip Larkin +16 more
TL;DR: The authors conclude that the inclusion of PC within the regular clinical framework for people with heart failure results in a substantial improvement in quality of life as well as comfort and dignity whilst dying.
Journal ArticleDOI
One evidence base; three stories: do opioids relieve chronic breathlessness?
Magnus Ekström,Sabrina Bajwah,Martin Bland,David C. Currow,Jamilla A Hussain,Miriam J. Johnson +5 more
TL;DR: The efficacy of low-dose systemic opioids for chronic breathlessness was questioned by the recent Cochrane review and the reasons for this conflicting finding were examined and the efficacy of systemic opioids was re-evaluated.
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Holistic services for people with advanced disease and chronic breathlessness: a systematic review and meta-analysis
Lisa Jane Brighton,Sophie Miller,Morag Farquhar,Sara Booth,Deokhee Yi,Wei Gao,Sabrina Bajwah,William D.-C. Man,Irene J Higginson,Matthew Maddocks +9 more
TL;DR: Holistic services for chronic breathlessness can reduce distress in patients with advanced disease and may improve psychological outcomes of anxiety and depression, and Therapeutic components of these services should be shared and integrated into clinical practice.
Journal ArticleDOI
Respiratory adverse effects of opioids for breathlessness: a systematic review and meta-analysis
Cindy A. Verberkt,Marieke H. J. van den Beuken-van Everdingen,Jos M. G. A. Schols,Sushma Datla,Carmen D. Dirksen,Miriam J. Johnson,Sander M. J. van Kuijk,Emiel F.M. Wouters,Daisy J.A. Janssen +8 more
TL;DR: There is no evidence of significant or clinically relevant respiratory adverse effects of opioids for chronic breathlessness and Heterogeneity of design and study population, and low study quality are limitations.
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