Non-pharmacological interventions for breathlessness management in patients with lung cancer: a systematic review

Abstract

The aim is to review the published scientific literature for studies evaluating non-pharmacological interventions for breathlessness management in patients with lung cancer. The following selection criteria were used to systematically search the literature: studies were to be published research or systematic reviews; they were to be published in English and from 1990 to 2007; the targeted populations were adult patients with dyspnoea/breathlessness associated with lung cancer; and the study reported on the outcomes from use of non-pharmacological strategies for breathlessness. This review retrieved five studies that met all inclusion criteria. All the studies reported the benefits of non-pharmacological interventions in improving breathlessness regardless of differences in clinical contexts, components of programmes and methods for delivery. Analysis of the available evidence suggests that tailored instructions delivered by nurses with sufficient training and supervision may have some benefits over other delivery approaches. Based on the results, non-pharmacological interventions are recommended as effective adjunctive strategies in managing breathlessness for patients with lung cancer. In order to refine such interventions, future research should seek to explore the core components of such approaches that are critical to achieving optimal outcomes, the contexts in which the interventions are most effective, and to evaluate the relative benefits of different methods for delivering such interventions.

Projected referral to other healthcare services in an outpatient palliative radiotherapy clinic

“…A pharmacological (i.e., opioid treatment) and nonpharmacological (i.e., psychosocial support, relaxation and breathing training) approach is warranted for the alleviation of dyspnea [34]. A systematic review of nonpharmacologic inter ventions in lung cancer has shown a significant impact on breathlessness and related distress [35]. As dyspnea has also been associated with other symptoms, such as pain or anxiety, treating related symptoms may also alleviate dyspnea severity [25].…”

Update on complex nonpharmacological interventions for breathlessness

“…Interventions to improve breathing efficiency Breathing retraining has been reported in all reviews to being an effective strategy to manage dyspnoea 9,10]. Breathing retraining techniques with good evidence to support their effectiveness included pursed lip breathing, diaphragmatic breathing, 'blow-as-you-go' and positioning and pacing techniques.…”

Evidence-Based Approaches to Other Symptoms in Advanced Cancer

“…6 A systematic review on nonpharmacological interventions in lung cancer 13 identified 3 RCTs of nursing multicomponent interventions for dyspnea, including psychosocial support, relaxation, and breathing training, mainly in patients with significant expected survival time (93 months); all showed a significant impact on breathlessness and related distress. 14 An RCT found that facial cooling with a fan also significantly reduced breathlessness. 15 Opening windows if possible, reducing room temperature, eliminating smoke, elevating the head of the bed, and humidifying air can also be helpful.…”