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An integrative review of systematic reviews related to the management of breathlessness in respiratory illnesses

An integrative review of systematic reviews related to the management of breathlessness in respiratory illnesses
An integrative review of systematic reviews related to the management of breathlessness in respiratory illnesses
Background: breathlessness is a debilitating and distressing symptom in a wide variety of diseases and still a difficult symptom to manage. An integrative review of systematic reviews of non-pharmacological and pharmacological interventions for breathlessness in non-malignant disease was undertaken to identify the current state of clinical understanding of the management of breathlessness and highlight promising interventions that merit further investigation.

Methods: systematic reviews were identified via electronic databases between July 2007 and September 2009. Reviews were included within the study if they reported research on adult participants using either a measure of breathlessness or some other measure of respiratory symptoms.

Results: in total 219 systematic reviews were identified and 153 included within the final review, of these 59 addressed non-pharmacological interventions and 94 addressed pharmacological interventions. The reviews covered in excess of 2000 trials. The majority of systematic reviews were conducted on interventions for asthma and COPD, and mainly focussed upon a small number of pharmacological interventions such as corticosteroids and bronchodilators, including beta-agonists. In contrast, other conditions involving breathlessness have received little or no attention and studies continue to focus upon pharmacological approaches. Moreover, although there are a number of non-pharmacological studies that have shown some promise, particularly for COPD, their conclusions are limited by a lack of good quality evidence from RCTs, small sample sizes and limited replication.

Conclusions: more research should focus in the future on the management of breathlessness in respiratory diseases other than asthma and COPD. In addition, pharmacological treatments do not completely manage breathlessness and have an added burden of side effects. It is therefore important to focus more research on promising non-pharmacological interventions
1471-2466
1-13
Bailey, Chris D.
af803055-3a2d-42cf-813c-47558ca0a3e5
Wagland, Richard
16a44dcc-29cd-4797-9af2-41ef87f64d08
Dabbour, Rasha
3bc24483-9f99-4b08-8e47-e6dbfd0aa7eb
Caress, Ann
70ef6cb6-cef3-43c1-b5a9-ad8c6acd050a
Smith, Jaclyn
6ebbfb93-cabd-454e-b0df-6273f7c2d4a7
Molassiotis, Alex
f4f18817-07cb-48ca-a51e-9504aa886a79
Bailey, Chris D.
af803055-3a2d-42cf-813c-47558ca0a3e5
Wagland, Richard
16a44dcc-29cd-4797-9af2-41ef87f64d08
Dabbour, Rasha
3bc24483-9f99-4b08-8e47-e6dbfd0aa7eb
Caress, Ann
70ef6cb6-cef3-43c1-b5a9-ad8c6acd050a
Smith, Jaclyn
6ebbfb93-cabd-454e-b0df-6273f7c2d4a7
Molassiotis, Alex
f4f18817-07cb-48ca-a51e-9504aa886a79

Bailey, Chris D., Wagland, Richard, Dabbour, Rasha, Caress, Ann, Smith, Jaclyn and Molassiotis, Alex (2010) An integrative review of systematic reviews related to the management of breathlessness in respiratory illnesses. BMC Pulmonary Medicine, 10 (63), 1-13. (doi:10.1186/1471-2466-10-63). (PMID:2114388)

Record type: Article

Abstract

Background: breathlessness is a debilitating and distressing symptom in a wide variety of diseases and still a difficult symptom to manage. An integrative review of systematic reviews of non-pharmacological and pharmacological interventions for breathlessness in non-malignant disease was undertaken to identify the current state of clinical understanding of the management of breathlessness and highlight promising interventions that merit further investigation.

Methods: systematic reviews were identified via electronic databases between July 2007 and September 2009. Reviews were included within the study if they reported research on adult participants using either a measure of breathlessness or some other measure of respiratory symptoms.

Results: in total 219 systematic reviews were identified and 153 included within the final review, of these 59 addressed non-pharmacological interventions and 94 addressed pharmacological interventions. The reviews covered in excess of 2000 trials. The majority of systematic reviews were conducted on interventions for asthma and COPD, and mainly focussed upon a small number of pharmacological interventions such as corticosteroids and bronchodilators, including beta-agonists. In contrast, other conditions involving breathlessness have received little or no attention and studies continue to focus upon pharmacological approaches. Moreover, although there are a number of non-pharmacological studies that have shown some promise, particularly for COPD, their conclusions are limited by a lack of good quality evidence from RCTs, small sample sizes and limited replication.

Conclusions: more research should focus in the future on the management of breathlessness in respiratory diseases other than asthma and COPD. In addition, pharmacological treatments do not completely manage breathlessness and have an added burden of side effects. It is therefore important to focus more research on promising non-pharmacological interventions

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Published date: 2010
Organisations: Health Sciences

Identifiers

Local EPrints ID: 176315
URI: https://eprints.soton.ac.uk/id/eprint/176315
ISSN: 1471-2466
PURE UUID: 31b0ccfc-0914-46d1-a0b7-e754401ea356
ORCID for Chris D. Bailey: ORCID iD orcid.org/0000-0002-7528-6264
ORCID for Richard Wagland: ORCID iD orcid.org/0000-0003-1825-7587

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Date deposited: 09 Mar 2011 10:09
Last modified: 19 Jun 2019 00:32

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