Yates, P., & Zhao, I. (2012). Update on complex nonpharmacological interventions for breathlessness. Current Opinion in Supportive and Palliative Care, 6(2), 144-152.doi: 10.1097/SPC.0b013e3283536413
The objective of the article is to report on strategies that patients with breathlessness find helpful and provide a review of current evidence about the role of nonpharmacologic interventions in managing dypsnea.
This article reports a secondary analysis of data from a trial in which self-report items were used to assess the impact of dyspnea on daily activities, feelings about breathlessness, and strategies adopted by patients. Authors also review the findings of several systematic reviews of nonpharmacologic interventions for breathlessness involving patients with chronic obstructive pulmonary disease (COPD) as well as lung cancer.
The multi-site study was conducted in an unspecified setting in Australia.
About half of patients reported that breathlessness had some effect on feelings of panic, fear, and anger. Activity modification was the most frequently used strategy. Cognitive coping strategies were used by 80% of respondents. Other strategies included breathing exercises and environmental modifications. The most helpful strategies related to activity modification. Of those who used coping and breathing exercises, 60% said they were helpful. Breathing retraining was found to be effective but is mainly studied in COPD. Exercise program findings are inconclusive, and interventions to reduce anxiety have had some positive outcomes. Other interventions such as music, distraction, and complementary medicine have insufficient evidence.
Patients in this study reported that activity management was helpful to manage dyspnea.
Findings suggest that educating appropriate patients about activity management can be helpful for them to manage symptoms of dyspnea. Limited evidence exists about the effects of other nonpharmacologic approaches that are effective for patients with cancer.