Dyspnea on Exercise Is Associated with Overall Symptom Burden in Patients with Chronic Respiratory Insufficiency

Rantala, Heidi; Leivo-Korpela, Sirpa; Lehto, Juho T.; Lehtimäki, Lauri

doi:10.1089/pmr.2020.0112

Cited by 3 publications

(5 citation statements)

References 30 publications

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“…In a similar context, Rantala et al analyzed the link between exertional dyspnea and the overall impact of symptoms in patients with chronic respiratory failure. Their findings indicate that patients with severe dyspnea report higher scores for anxiety and depression, highlighting the necessity for a comprehensive evaluation of symptoms and appropriate treatment that addresses the extended burden of symptoms exacerbated by increasing dyspnea severity [ 29 ].…”

Section: Discussionmentioning

confidence: 99%

Interactions between Cognitive, Affective, and Respiratory Profiles in Chronic Respiratory Disorders: A Cluster Analysis Approach

Buican,

Gheorman,

Udriştoiu

et al. 2024

Diagnostics

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This study conducted at Leamna Pulmonology Hospital investigated the interrelations among cognitive, affective, and respiratory variables within a cohort of 100 patients diagnosed with chronic respiratory conditions, utilizing sophisticated machine learning-based clustering techniques. Spanning from October 2022 to February 2023, hospitalized individuals confirmed to have asthma or COPD underwent extensive evaluations using standardized instruments such as the mMRC scale, the CAT test, and spirometry. Complementary cognitive and affective assessments were performed employing the MMSE, MoCA, and the Hamilton Anxiety and Depression Scale, furnishing a holistic view of patient health statuses. The analysis delineated three distinct clusters: Moderate Cognitive Respiratory, Severe Cognitive Respiratory, and Stable Cognitive Respiratory, each characterized by unique profiles that underscore the necessity for tailored therapeutic strategies. These clusters exhibited significant correlations between the severity of respiratory symptoms and their effects on cognitive and affective conditions. The results highlight the benefits of an integrated treatment approach for COPD and asthma, which is personalized based on the intricate patterns identified through clustering. Such a strategy promises to enhance the management of these diseases, potentially elevating the quality of life and everyday functionality of the patients. These findings advocate for treatment customization according to the specific interplays among cognitive, affective, and respiratory dimensions, presenting substantial prospects for clinical advancement and pioneering new avenues for research in the domain of chronic respiratory disease management.

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Section: Discussionmentioning

confidence: 99%

Interactions between Cognitive, Affective, and Respiratory Profiles in Chronic Respiratory Disorders: A Cluster Analysis Approach

Buican,

Gheorman,

Udriştoiu

et al. 2024

Diagnostics

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“…The minimally important difference (MID) for each ESAS domain has been described in the oncology field, with 1-point per domain often used (24). ESAS has also been used to measure symptoms in both ambulatory COPD and ILD patients (13,14,25).…”

Section: Edmonton Symptom Assessment Scorementioning

confidence: 99%

“…In COPD patients, the most common symptoms reported are fatigue, dyspnea and pain, whereas dyspnea and fatigue are the most troublesome in ILD patients (12,13). Furthermore, both respiratory and non-respiratory symptoms have been shown to be accentuated with increasing dyspnea severity (14). A previous study from our center demonstrated improvements in sleep, cough, and pain in LTx candidates, but differences between COPD and ILD were not evaluated and may have important management considerations (15).…”

Section: Introductionmentioning

confidence: 99%

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Symptoms and disease severity in lung transplant candidates co-managed with palliative care

Minuk¹,

Chohan²,

Kumbhare³

et al. 2023

Ann Palliat Med

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Background: Lung transplant (LTx) candidates experience significant respiratory symptoms often necessitating palliative care (PC) support. We aimed to describe symptoms experienced by interstitial lung disease (ILD) and chronic obstructive pulmonary disease (COPD) LTx candidates referred for PC using the Edmonton Symptom Assessment Scale (ESAS) and to assess the change in ESAS in relation to pre-LTx exercise capacity, oxygen requirements, and respiratory exacerbations. Understanding symptom trajectory of these two patient groups will help inform PC management. Methods: Single centre, retrospective cohort of 102 ILD and 24 COPD LTx candidates who were assessed in the Toronto Transplant PC Clinic (TPCC) from 2014-2017. Chi-square and t-tests were used to compare clinical characteristics, physiological parameters, and ESAS scores. Results:The most common symptom in ILD and COPD patients was dyspnea (median score of 8, cough 7, fatigue 6). ILD patients reported higher cough scores (7 vs. 4, P<0.001). There was no association between the change in ESAS domains and six-minute walk distance (6MWD), oxygen requirements, or respiratory exacerbations, despite increased oxygen requirements and a greater decline in 6MWD in ILD compared to COPD pre-LTx (−47 vs. −8 meters, P=0.01). ILD candidates who were delisted/died compared to those transplanted, experienced worse depression (median ESAS; 4.5 vs. 1), anxiety (5.5 vs. 2) and dyspnea (9.5 vs. 8); P<0.05.Conclusions: ILD patients had similar symptoms as COPD patients, despite increased oxygen requirements and decreasing 6MWD pre-LTx. This study highlights the importance of symptom management of LTx candidates co-managed with PC, independent of traditional measures of disease severity.

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“…Disease specific management alone does not guarantee symptom control. Breathlessness increases with disease progression, resulting in poor quality of life [7,8], increased disability and high health and social care costs [9]. This is often driven by repeated Emergency Department (ED) attendance and hospitalisations [10][11][12].…”

Section: Introductionmentioning

confidence: 99%

A randomised, controlled, feasibility trial of an online, self-guided breathlessness supportive intervention (SELF-BREATHE) for individuals with chronic breathlessness due to advanced disease

et al. 2023

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IntroductionSELF-BREATHE is a complex, transdiagnostic, supportive, digital breathlessness intervention co-developed with patients. SELF-BREATHE seeks to build capacity and resilience within health services by improving the lives of people with chronic breathlessness using nonpharmacological, self-management approaches. This study aimed to determine whether SELF-BREATHE is feasible to deliver and acceptable to patients living with chronic breathlessness.MethodsDesign: A parallel, two arm, single blind, single centre, randomised controlled mixed-methods feasibility trial with participants allocated to 1) intervention group (SELF-BREATHE) or 2) control group (usual NHS care).SettingLarge multisite NHS Foundation Trust in Southeast London.ParticipantsPatients living with chronic breathlessness due to advanced malignant or non-malignant disease(s).InterventionParticipants were randomly allocated (1:1) to an online, self-guided, breathlessness, supportive intervention (SELF-BREATHE) and usual care or usual care alone, over six weeks.A priori progression criteria≥30% of eligible patients given an information sheet consented to participate,≥60% of participants logged on and accessed SELF–BREATHE within 2 weeks, ≥70% of patients reported the methodology and intervention as acceptable.ResultsBetween January 2021 and January 2022, 52/110 (47%) eligible patients consented and were randomised. Of those randomised to SELF-BREATHE, 19/26 (73%) logged on and used SELF-BREATHE for a mean (sd, range) of 9 (8, 1–33) times over 6-weeks. Thirty-six of the 52 (70%) randomised participants completed and returned the end of study postal questionnaires. SELF-BREATHE users reported it to be acceptable. Post intervention qualitative interviews demonstrated that SELF-BREATHE was acceptable and valued, by users, improving breathlessness during daily life and at points of breathlessness crisis.ConclusionThese data support the feasibility of moving to a fully powered, efficacy, randomised controlled trial with minor modifications to minimise missing data (i.e., multiple methods for data collection, face-to-face, telephone, video assessment andviapost).

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Dyspnea on Exercise Is Associated with Overall Symptom Burden in Patients with Chronic Respiratory Insufficiency

Cited by 3 publications

References 30 publications

Interactions between Cognitive, Affective, and Respiratory Profiles in Chronic Respiratory Disorders: A Cluster Analysis Approach

Interactions between Cognitive, Affective, and Respiratory Profiles in Chronic Respiratory Disorders: A Cluster Analysis Approach

Symptoms and disease severity in lung transplant candidates co-managed with palliative care

A randomised, controlled, feasibility trial of an online, self-guided breathlessness supportive intervention (SELF-BREATHE) for individuals with chronic breathlessness due to advanced disease

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