Ben-Aharon, I., Gafter-Gvili, A., Paul, M., Leibovici, L., & Stemmer, S.M. (2008). Interventions for alleviating cancer-related dyspnea: A systematic review. Journal of Clinical Oncology, 26(14), 2396-2404.doi: 10.1200/JCO.2007.15.5796
The objective of this study was to systematically review the evidence for the efficacy of pharmacologic and nonpharmacologic treatments in alleviating dyspnea in patients with terminal cancer.
Literature evaluated included 37 studies, plus one abstract initially reviewed. A final set of 18 studies was included; 7 assessed opioids, 6 assessed oxygen- or helium-enriched air, 1 assessed furosemide, and 4 assessed nonpharmacologic interventions. Meta-analysis was not completed due to the paucity of studies and heterogeneous outcome measures.
Sample Size Across Studies:
Sample Range Across Studies:
With respect to gender, age, and diagnosis within the sample, the opioids subgroup included both genders. The median age range was 56–73 years. The majority had primary lung cancer, and both opioid-tolerant and opioid-naïve participants were included.
The oxygen or helium subgroup included both genders. The median age range was 64–72 years. The majority had primary lung cancer.
No comment was available on gender or age for the nonpharmacologic subgroup, but the primary diagnosis was lung cancer.
The primary outcome was subjective dyspnea relief according to the visual analog scale (VAS) or dyspnea intensity according to the modified Borg scale. The secondary outcome was oxygen saturation and adverse effects.
Acknowledging the paucity of evidence from randomized controlled trials to support the interventions is important.
Limitations of this review were
A major research opportunity exists to further document outcomes from nurse-led dyspnea interventions.