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

Chris D. Bailey, Richard Wagland, Rasha Dabbour, Ann Caress, Jaclyn Smith, Alex Molassiotis

Research output: Contribution to journalArticle

19 Citations (Scopus)

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.

Original languageEnglish
Article number63
JournalBMC Pulmonary Medicine
Volume10
DOIs
Publication statusPublished - 9 Dec 2010
Externally publishedYes

Fingerprint

Dyspnea
Pharmacology
Chronic Obstructive Pulmonary Disease
Asthma
Research
Bronchodilator Agents
Sample Size
Adrenal Cortex Hormones
Databases

Cite this

Bailey, Chris D. ; Wagland, Richard ; Dabbour, Rasha ; Caress, Ann ; Smith, Jaclyn ; Molassiotis, Alex. / An integrative review of systematic reviews related to the management of breathlessness in respiratory illnesses. In: BMC Pulmonary Medicine. 2010 ; Vol. 10.
@article{16cd93c0eae0486c98d5f6cd27eb2028,
title = "An integrative review of systematic reviews related to the management of breathlessness in respiratory illnesses",
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.",
keywords = "asthma, Chronic obstructive pulmonary disease, pulmonary arterial hypertension, Idiopathic pulmonary fibrosis, interstital lung disease",
author = "Bailey, {Chris D.} and Richard Wagland and Rasha Dabbour and Ann Caress and Jaclyn Smith and Alex Molassiotis",
year = "2010",
month = "12",
day = "9",
doi = "10.1186/1471-2466-10-63",
language = "English",
volume = "10",
journal = "BMC Pulmonary Medicine",
issn = "1471-2466",
publisher = "BioMed Central",

}

An integrative review of systematic reviews related to the management of breathlessness in respiratory illnesses. / Bailey, Chris D.; Wagland, Richard; Dabbour, Rasha; Caress, Ann; Smith, Jaclyn; Molassiotis, Alex.

In: BMC Pulmonary Medicine, Vol. 10, 63, 09.12.2010.

Research output: Contribution to journalArticle

TY - JOUR

T1 - An integrative review of systematic reviews related to the management of breathlessness in respiratory illnesses

AU - Bailey, Chris D.

AU - Wagland, Richard

AU - Dabbour, Rasha

AU - Caress, Ann

AU - Smith, Jaclyn

AU - Molassiotis, Alex

PY - 2010/12/9

Y1 - 2010/12/9

N2 - 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.

AB - 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.

KW - asthma

KW - Chronic obstructive pulmonary disease

KW - pulmonary arterial hypertension

KW - Idiopathic pulmonary fibrosis

KW - interstital lung disease

UR - http://www.scopus.com/inward/record.url?scp=78649761761&partnerID=8YFLogxK

U2 - 10.1186/1471-2466-10-63

DO - 10.1186/1471-2466-10-63

M3 - Article

VL - 10

JO - BMC Pulmonary Medicine

JF - BMC Pulmonary Medicine

SN - 1471-2466

M1 - 63

ER -