• J Palliat Med · Oct 2013

    Characterizing episodic breathlessness in patients with advanced disease.

    • Vera Weingärtner, Claudia Bausewein, Irene J Higginson, Christine Scheve, Fliss E M Murtagh, Raymond Voltz, and Steffen T Simon.
    • 1 Department of Palliative Medicine, Center of Integrated Oncology (BMBF O1KN1106), Cologne/Bonn and Clinical Trials Unit, University Hospital of Cologne , Cologne, Germany .
    • J Palliat Med. 2013 Oct 1;16(10):1275-9.

    BackgroundEpisodic breathlessness is a common and distressing symptom in advanced cancer and nonmalignant diseases but there is a lack of evidence on the characteristics of the symptom.ObjectiveThe aim of this study was to determine the duration, severity, frequency and timing of breathlessness episodes in patients with advanced diseases.MethodsExplorative analysis of pooled cross-sectional data on episodic breathlessness collected in personal interviews with patients suffering from chronic obstructive pulmonary disease, lung cancer, chronic heart failure, or motor neuron disease. Interviews were conducted as part of two studies in the UK and in Germany that included the same questions on duration, frequency, timing, and peak severity of breathlessness episodes. Severity was measured on the modified Borg scale (0-10).ResultsOne hundred and twenty-nine patients, 61% male, mean age of 67 years (SD 9.8), were included. The episodes described were mainly short (75%≤10 min), severe (mean 6.5 (SD 2.4), and occurred mostly daily. Frequency of episodes triggered by exertion could hardly be determined as these varied depending on patients' activity.ConclusionOur study reveals clinically important information on the characteristics of episodic breathlessness in patients with advanced diseases. Findings have implications for the treatment of episodic breathlessness since most short-acting drugs in use have a longer onset of action compared to the duration of episodes. We need to determine patient-relevant therapeutic targets for future evaluation of adequate pharmacological and nonpharmacological management options that are urgently warranted.

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