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Results of a pilot investigation into a complex intervention for breathlessness in advanced chronic obstructive pulmonary disease (COPD): Brief report

  • Morag Farquhar (a1), Irene J. Higginson (a2), Petrea Fagan (a3) and Sara Booth (a3)
Abstract
Objective:

Breathlessness is the most common devastating symptom of advanced chronic obstructive pulmonary disease (COPD). The Breathlessness Intervention Service (BIS) is a multidisciplinary service that uses both pharmacological and non-pharmacological evidence-based interventions to reduce the impact of the symptom. The results of a Phase II evaluation of the service are reported.

Method:

Pretest - posttest analysis of non-randomized data was performed for 13 patients with severe advanced COPD referred to BIS.

Results:

Mean VAS-Distress scores (primary outcome measure) decreased (improved) for the group between baseline and follow up suggesting a clinically significant improvement: 6.88 (SD = 2.50) to 5.25 (SD = 2.99). At an individual level, 11 of the 13 patients showed a decrease in their distress due to breathlessness, and for eight of these this was clinically significant (range of all decreases 0.3–7.1 cm). Changes in secondary outcome measures are also reported.

Significance of results:

The Breathlessness Intervention Service appears to reduce distress due to breathlessness among patients with advanced COPD. A Phase III fully-powered randomized controlled trial is warranted.

Copyright
Corresponding author
Address correspondence and reprint requests to: Morag Farquhar, Department of Public Health & Primary Care, Institute of Public Health, Robinson Way, Cambridge, CB2 0SR, England. E-mail: mcf22@medschl.cam.ac.uk
References
Hide All
Booth, S. & Adams, L. (2001). The shuttle walking test: A reproducible method for evaluating functional capacity in people with advanced cancer. Thorax, 56, 146150.
Booth, S., Farquhar, M., Gysels, M., et al. (2006). The impact of a breathlessness intervention service (BIS) on the lives of patients with intractable dyspnoea: A qualitative Phase I study. Palliative & Supportive Care, 4, 287293.
Booth, S., Kelly, M., Cox, N.P.G., et al. (1996). Does oxygen help dyspnoea in cancer patients? American Journal of Respiratory Critical Care Medicine, 153, 15151518.
Booth, S., Silvester, S. & Todd, C. (2003). Breathlessness in cancer and chronic obstructive pulmonary disease: Using a qualitative approach to describe the experience of patients and carers. Palliative & Supportive Care, 1, 337344.
Bredin, M., Corner, J., Krishnasamy, M., et al. (1999). Multicentre randomised control trial of nursing intervention for breathlessness in patients with lung cancer. British Medical Journal, 318, 901904.
Brenes, G.A. (2003). Anxiety and chronic obstructive pulmonary disease: Prevalence, impact, and treatment. Psychosomatic Medicine, 65, 963970.
Charles, M., Reymond, L. & Israel, F. (2008). Relief of incident dyspnea in palliative cancer patients: a pilot randomized, controlled trial comparing nebulized hydromorphone, systemic hydromorphone, and nebulized saline. Journal of Pain and Symptom Management, 36, 2938.
Corner, J., Plant, H., A'Hern, R., et al. (1996). Non-pharmacological intervention for breathlessness in lung cancer. Palliative Medicine, 10, 299305.
Farquhar, M., Higginson, I.J., Fagan, P., et al. (2009a). The feasibility of a single-blinded fast-track pragmatic randomised controlled trial of a complex intervention for breathlessness in advanced disease. BMC Palliative Care, 8, 9.
Farquhar, M., Higginson, I.J. & Booth, S. (2009b). Fast-track trials in palliative care: An alternative randomized controlled trial design. Journal of Palliative Medicine, 12, 213.
Guyatt, G.H., Berman, L.B., Townsend, M., et al. (1987). A measure of quality of life for clinical trials in chronic lung disease. Thorax, 42, 773778.
Higginson, I.J., Vivat, B., Silber, E., et al. (2006). Study protocol: Delayed intervention randomised controlled trial within the Medical Research Council (MRC) Framework to assess the effectiveness of a new palliative care service. BMC Palliative Care, 2, 7.
Matthews, J.N.S., Altman, D.G., Campbell, M.J., et al. (1990). Analysis of serial measurements in medical research. British Medical Journal, 800, 280281.
Medical Research Council. (2000). A Framework for Development and Evaluation of RCTs for Complex Interventions to Improve Health. London: Medical Research Council.
Murray, C.J.L. & Lopez, D. (1997). Alternative projections of mortality and disability by cause 1990–2020: Global Burden of Disease Study. Lancet, 349, 14981504.
Puhan, M.A., Frey, M., Buechi, S., et al. (2008). The minimal important difference of the Hospital Anxiety and Depression Scale in patients with chronic obstructive pulmonary disease. Health and Quality of Life Outcomes, 6, 46.
Roberts, D.K., Thorne, S.E. & Pearson, C. (1993). The experiences of dyspnea in late-stage cancer. Patients' and nurses' perspectives. Cancer Nursing, 16, 310320.
Rocker, G.M., Sinuff, T., Horton, R., et al. (2007). Advanced chronic obstructive pulmonary disease: innovative approaches to palliation. Journal of Palliative Medicine, 10, 783797.
Zigmond, A.S. & Snaith, R.P. (1983). The Hospital Anxiety and Depression Scale. Acta Psychiatrica Scandinavica, 67, 361370.
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Palliative & Supportive Care
  • ISSN: 1478-9515
  • EISSN: 1478-9523
  • URL: /core/journals/palliative-and-supportive-care
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