Top

BMC Pulmonary Medicine

Published in:

Open Access 01-12-2010 | Research article

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

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

Published in: BMC Pulmonary Medicine | Issue 1/2010

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.

Available only for authorised users

American Thoracic Society: Dyspnea: mechanisms, assessment, and management: a consensus statement. Am J Respir Crit Care Med. 1999, 159: 321-340.

Karnani NG, Reisfield GM, Wilson GR: Evaluation of chronic dyspnea. Am Fam Physician. 2005, 71 (8): 1529-1537.PubMed

Cox C: Non-pharmacological treatment of breathlessness. Nurs Standard. 2002, 16 (24): 33-36.

Luddington L, Cox S, Higginson I, Livesley B: The need for palliative care for patients with non-cancer diseases: a review of the evidence. Int J Palliat Nurs. 2001, 7 (5): 221-226.PubMed

Rawlinson F: Dyspnoea and cough. Eur J Palliat Care. 2000, 7 (5): 161-164.

Cranston JM, Crockett A, Currow D: Oxygen therapy for dyspnoea in adults. Cochrane Database of Systematic Reviews. 2008, CD004769-

Bailey PH: The dyspnea-anxiety-dyspnea cycle-COPD patients' stories of breathlessness: "it's scary/when you can't breathe". Qual Health Res. 2004, 14 (6): 760-778. 10.1177/1049732304265973.PubMed

Harris S: COPD and coping with breathlessness at home: a review of the literature. Br J Community Nur. 2007, 12 (9): 411-415.

Seamark DA, Blake SD, Seamark CJ: Living with severe chronic obstructive pulmonary disease: perceptions of patients and their carers. Pallit Med. 2004, 18 (7): 619-625. 10.1191/0269216304pm928oa.

10.

Simon NM, Weiss AM, Kradin R, Evans KC, Reese HE, Otto MW, Oppenheimer JE, Smoller JW, Zalta A, Worthington III JJ, Pollack MH: The relationship of anxiety disorders, anxiety sensitivity and pulmonary dysfunction with dyspnea-related distress and avoidance. J Nerv Ment Dis. 2006, 194 (12): 951-957. 10.1097/01.nmd.0000249062.25829.53.PubMed

11.

Smoller JW, Pollack MH, Otto MW, Rosenbaum JF, Kradin RL: Panic anxiety, dyspnea, and respiratory disease. Theoretical and clinical considerations. Am J Respir Crit Care Med. 1996, 154 (1): 6-17.PubMed

12.

Clark AL, Sparrow JL, Coats AJS: Muscle fatigue and dyspnoea in chronic heart failure: two sides of the same coin?. Eur Heart J. 1995, 16 (1): 49-52.PubMed

13.

Witte KA, Clark AL: Dyspnoea versus fatigue: additional prognostic information from symptoms in chronic heart failure?. Eur J of Heart Failure. 2008, 10 (12): 1224-1228. 10.1016/j.ejheart.2008.09.017.

14.

Maurer J, Rebbapragada V, Borson S, Goldstein R, Kunik ME, Yohannes AM, Hanania NA: Anxiety and depression in COPD. Chest. 2008, 134: 43S-56S. 10.1378/chest.08-0342.PubMedPubMedCentral

15.

Roberts DK, Thorne SE, Pearson C: The experience of dyspnoea in late stage cancer: patients' and nurse perspectives. Cancer Nurs. 1993, 16 (4): 310-320. 10.1097/00002820-199308000-00008.PubMed

16.

Abidov A, Rozanski A Hachamovitch R, Hayes SW, Aboul-Enein F, Cohen I, Friedman JD Germano G, Berman DS: Prognostic significance of dyspnea in patients referred for cardiac stress testing. N Eng J Med. 2005, 353: 1889-1898. 10.1056/NEJMoa042741.

17.

Frostad A, Soyseth V, Haldorsen T, Andersen A, Gulsvik A: Respiratory symptoms and long-term cardiovascular mortality. Respir Med. 2007, 101 (11): 2289-2296. 10.1016/j.rmed.2007.06.023.PubMed

18.

Tessier JF, Nejjari C, Letenneur L, Filleul L, Marty ML, Barberger Gateau P, Dartigues JF: Dyspnea and 8-year mortality among elderly men and women: the PAQUID cohort study. Eur J of Epidemiology. 2001, 17: 223-229. 10.1023/A:1017977715073.

19.

Jones PW: Activity limitation and quality of life in COPD. J COPD. 2007, 4: 273-278. 10.1080/15412550701480265.

20.

Donaldson GC, Wilkinson TMA, Hurst JR, Perera WR, Wedzicha JA: Exacerbations and time spent outdoors in chronic obstructive pulmonary disease. Am J Respir Crit Care Med. 2005, 171: 446-452. 10.1164/rccm.200408-1054OC.PubMed

21.

Murray CJL, Lopez AD: Alternative projections of mortality and disability by cause 1990-2020: global burden of disease study. Lancet. 1997, 349: 1498-1504. 10.1016/S0140-6736(96)07492-2.PubMed

22.

Lopez AD, Murray CCJL: The global burden of disease, 1990-2020. Nat Med. 1998, 4 (11): 1241-1243. 10.1038/3218.PubMed

23.

Gysels M, Higginson IJ: Access to Services for Patients with Chronic Obstructive Pulmonary Disease: The Invisibility of Breathlessness. J Pain & Symptom Manage. 2008, 36: 451-460.

24.

Gore JM, Brophy CJ, Greenstone MA: How well do we care for patients with end stage chronic obstructive pulmonary disease (COPD)? A comparison of palliative care and quality of life in COPD and lung cancer. Thorax. 2000, 55: 1000-1006. 10.1136/thorax.55.12.1000.PubMedPubMedCentral

25.

Ripamonti C, Fusco F: Respiratory problems in advanced cancer. Support Care Cancer. 2001, 10: 204-216. 10.1007/s005200100296.PubMed

26.

Bruera E, Schmitz B, Pither J, Neuman CM, Hanson J: The frequency and correlates of dyspnea in patients with advanced cancer. J Pain Symptom Manage. 2006, 19: 357-362. 10.1016/S0885-3924(00)00126-3.

27.

Booth S, Moosavi SH, Higginson IJ: The etiology and management of intractable breathlessness in patients with advanced cancer: a systematic review of pharmacological therapy. Nature Clin Pract. 2008, 5 (2 February): 90-100. 10.1038/ncponc1034.

28.

Bauswein C, Booth S, Gysels M, Higginson IJ: Non-pharmacological interventions for breathlessness in advanced stages of malignant and non-malignant diseases (Review). Cochrane Database of Systematic Reviews. 2008, CD005623-

29.

Rodrigo G, Pollack C, Rodrigo C, Rowe BH: Heliox for nonintubated acute asthma patients. Cochrane Database of Systematic Reviews. 2006, CD002884-

30.

Ram FSF, Wellington SR, Barnes NC: Inspiratory muscle training for asthma. Cochrane Database of Systematic Reviews. 2003, CD003792-

31.

Ho AM-H, Lee A, Karmaker MK, Dion PW, Chung DC, Contardi L-A H: Heliox vs air-oxygen mixtures for the treatment of patients with acute asthma - A systematic review. Chest. 2003, 123: 882-890. 10.1378/chest.123.3.882.PubMed

32.

McCarney RW, Brinkhaus B, Lasserson TJ, Linde K: Acupuncture for chronic asthma. Cochrane Database of Systematic Reviews. 2003, CD000008-

33.

Ram FSF, Robinson SM, Black PN, Picot J: Physical training for asthma. Cochrane Database of Systematic Reviews. 2005, CD001116-

34.

Holloway E, Ram FSF: Breathing exercises for asthma. Cochrane Database of Systematic Reviews. 2004, CD001277-

35.

Cheng J, Pan T, Ye GH, Liu Q: Calorie controlled diet for chronic asthma. Cochrane Database of Systematic Reviews. 2003, CD004674-

36.

Thien FCK, De Luca S, Woods R, Abramson MJ: Dietary marine fatty acids (fish oil) for asthma in adults and children. Cochrane Database of Systematic Reviews. 2002, CD001283-

37.

Ram FSF, Ardern KD: Dietary salt reduction or exclusion for allergic asthma. Cochrane Database of Systematic Reviews. 2004, CD000436-

38.

Ram FS, Ardern KD: Tartrazine exclusion for allergic asthma. Cochrane Database of Systematic Reviews. 2001, CD000460-

39.

Ram FSF, Rowe BH, Kaur B: Vitamin C supplementation for asthma. Cochrane Database of Systematic Reviews. 2004, CD000993-

40.

McCarney RW, Linde K, Lasserson TJ: Homeopathy for chronic asthma. Cochrane Database of Systematic Reviews. 2004, CD000353-

41.

Gotzsche PC, Johansen HK, Schmidt LM, Burr ML: House dust mite control measures for asthma. Cochrane Database of Systematic Reviews. 2004, CD001187-

42.

Kilburn S, Lasserson TJ, McKean M: Pet allergen control measures for allergic asthma in children and adults. Cochrane Database of Systematic Reviews. 2001, CD002989-

43.

Singh M, Bara A, Gibson P: Humidity control for chronic asthma. Cochrane Database of Systematic Reviews. 2002, CD003563-

44.

Blackhall K, Appleton S, Cates CJ: Ionisers for chronic asthma. Cochrane Database of Systematic Reviews. 2003, CD002986-

45.

Gibson PG, Powell H, Coughlan J, Wilson AJ, Hensley MJ, Abramson M, Bauman A, Walters EH: Limited (information only) patient education programs for adults with asthma. Cochrane Database of Systematic Reviews. 2002, CD001005-

46.

Powell H, Gibson PG: Options for self-management education for adults with asthma. Cochrane Database of Systematic Reviews. 2002, CD004107-

47.

Gibson PG, Powell H, Coughlan J, Wilson AJ, Abramson M, Haywood P, Bauman A, Hensley MJ, Walters EH: Self-management education and regular practitioner review for adults with asthma. Cochrane Database of Systematic Reviews. 2002, CD001117-

48.

Hondras MA, Linde K, Jones AP: Manual therapy for asthma. Cochrane Database of Systematic Reviews. 2005, CD001002-

49.

Ram FSF, Jones A, Fay JK: Primary care based clinics for asthma. Cochrane Database of Systematic Reviews. 2002, CD003533-

50.

Yorke J, Fleming SL, Shuldham CM: Psychological interventions for adults with asthma. Cochrane Database of Systematic Reviews. 2006, CD002982-

51.

Smith J, Mugford M, Holland R, Candy B, Noble MJ, Harrison BDW, Koutantji M, Upton C, Harvey I: A systematic review to examine the impact of psycho-educational interventions on health outcomes and costs in adults and children with difficult asthma. Health Technol Assess. 2005, 9 (23): iii-iv, 1-167.PubMed

52.

Toelle BG, Ram FSF: Written individualised management plans for asthma in children and adults. Cochrane Database of Systematic Reviews. 2004, CD002171-

53.

Ram FSF, Wellington SR, Rowe B, Wedzicha JA: Non-invasive positive pressure ventilation for treatment of respiratory failure due to severe acute exacerbations of asthma. Cochrane Database of Systematic Reviews. 2005, CD004360-

54.

Allam MF, Lucena RA: Selenium supplementation for asthma. Cochrane Database of Systematic Reviews. 2004, CD003538-

55.

Dennis J, Cates CJ: Alexander technique for chronic asthma. Cochrane Database of Systematic Reviews. 2000, CD000995-

56.

Campbell F, Jones K, Gibson P: Feather versus non-feather bedding for asthma. Cochrane Database of Systematic Reviews. 2000, CD002154-

57.

Westby M, Benson M, Gibson P: Anticholinergic agents for chronic asthma in adults. Cochrane Database of Systematic Reviews. 2004, CD003269-

58.

Salpeter S, Ormiston T, Salpeter E, Wood-Baker R: Cardioselective beta-blockers for reversible airway disease. Cochrane Database of Systematic Reviews 2002. 2002, CD002992-

59.

Manser R, Reid D, Abramson M: Corticosteroids for acute severe asthma in hospitalised patients. Cochrane Database of Systematic Reviews. 2001, CD001740-

60.

Rowe BH, Spooner CH, Ducharme FM, Bretzlaff JA, Bota GW: Corticosteroids for preventing relapse following acute exacerbations of asthma. Cochrane Database of Systematic Reviews. 2001, CD000195-

61.

Travers A, Jones AP, Kelly K, Barker SJ, Camargo CA, Rowe BH: Intravenous beta2-agonists for acute asthma in the emergency department. Cochrane Database of Systematic Reviews. 2001, CD002988-

62.

Walters EH, Gibson PG, Lasserson TJ, Walters JAE: Long-acting beta2-agonists for chronic asthma in adults and children where background therapy contains varied or no inhaled corticosteroid. Cochrane Database of Systematic Reviews. 2007, CD001385-

63.

Richter B: Long- and Short-Acting Inhaled Beta~2-Agonists: Do Benefit-Risk-Ratios Differ in the Treatment of Bronchial Asthma and COPD?. Z Allg Med. 2006, 82 (6): 253-258. 10.1055/s-2006-933519.

64.

Ducharme F, Schwartz Z, Kakuma R: Addition of anti-leukotriene agents to inhaled corticosteroids for chronic asthma. Cochrane Database of Systematic Reviews 2004. 2004, CD003133-

65.

Ducharme FM, Di Salvio F: Anti-leukotriene agents compared to inhaled corticosteroids in the management of recurrent and/or chronic asthma in adults and children. Cochrane Database of Systematic Reviews. 2004, CD002314-

66.

Ni Chroinin M, Greenstone IR, Ducharme FM: Addition of inhaled long-acting beta2-agonists to inhaled steroids as first line therapy for persistent asthma in steroid-naive adults. Cochrane Database of Systematic Reviews. 2004, CD005307-

67.

Parameswaran K, Belda J, Rowe BH: Addition of intravenous aminophylline to beta2-agonists in adults with acute asthma. Cochrane Database of Systematic Reviews. 2000, CD002742-

68.

Greenstone IR, Ni Chroinin MN, Masse V, Danish A, Magdalinos H, Zhang X, Ducharme FM: Combination of inhaled long-acting beta2-agonists and inhaled steroids versus higher dose of inhaled steroids in children and adults with persistent asthma. Cochrane Database of Systematic Reviews. 2005, CD005533-

69.

Camargo CA, Spooner CH, Rowe BH: Continuous versus intermittent beta-agonists for acute asthma. Cochrane Database of Systematic Reviews. 2003, CD001115-

70.

Walters EH, Walters J, Gibson P, Jones PW: Inhaled short acting beta2-agonist use in chronic asthma: regular versus as needed treatment. Cochrane Database of Systematic Reviews. 2003, CD001285-

71.

Gibson PG, Powell H, Ducharme F: Long-acting beta2-agonists as an inhaled corticosteroid-sparing agent for chronic asthma in adults and children. Cochrane Database of Systematic Reviews. 2005, CD005076-

72.

Ducharme FM, Lasserson TJ, Cates CJ: Long-acting beta2-agonists versus anti-leukotrienes as add-on therapy to inhaled corticosteroids for chronic asthma. Cochrane Database of Systematic Reviews. 2006, CD003137-

73.

Ni Chroinin M, Greenstone IR, Danish A, Magdolinos H, Masse V, Zhang X, Ducharme FM: Long-acting beta2-agonists versus placebo in addition to inhaled corticosteroids in children and adults with chronic asthma. Cochrane Database of Systematic Reviews. 2005, CD005535-

74.

Shah L, Wilson AJ, Gibson PG, Coughlan J: Long-acting beta2-agonists versus theophylline for maintenance treatment of asthma. Cochrane Database of Systematic Reviews. 2003, CD001281-

75.

Walters EH, Walters JAE, Gibson PW: Regular treatment with long acting beta agonists versus daily regular treatment with short acting beta agonists in adults and children with stable asthma. Cochrane Database of Systematic Reviews. 2002, CD003901-

76.

Abramson MJ, Puy RM, Weiner JM: Allergen immunotherapy for asthma. Cochrane Database of Systematic Reviews. 2003, CD001186-

77.

Walker S, Monteil M, Phelan K, Lasserson TJ, Walters EH: Anti-IgE for chronic asthma in adults and children. Cochrane Database of Systematic Reviews. 2006, CD003559-

78.

Graham V, Lasserson TJ, Rowe BH: Antibiotics for acute asthma. Cochrane Database of Systematic Reviews. 2001, CD002741-

79.

Dean T, Dewey A, Bara A, Lasserson TJ, Walters EH: Azathioprine as an oral corticosteroid sparing agent for asthma. Cochrane Database of Systematic Reviews. 2003, CD003270-

80.

Adams N, Bestall J, Jones P: Beclomethasone at different doses for chronic asthma. Cochrane Database of Systematic Reviews. 1999, CD002879-

81.

Adams N, Bestall JM, Jones PW: Beclomethasone versus budesonide for chronic asthma. Cochrane Database of Systematic Reviews. 2000, CD003530-

82.

Adams NP, Bestall JB, Malouf R, Lasserson TJ, Jones PW: Beclomethasone versus placebo for chronic asthma. Cochrane Database of Systematic Reviews. 2005, CD002738-

83.

Adams N, Bestall J, Jones P: Budesonide at different doses for chronic asthma. Cochrane Database of Systematic Reviews. 2000, CD003271-

84.

Adams N, Bestall J, Jones PW: Budesonide versus placebo for chronic asthma in children and adults. Cochrane Database of Systematic Reviews. 1999, CD003274-

85.

Bara AI, Barley EA: Caffeine for asthma. Cochrane Database of Systematic Reviews. 2001, CD001112-

86.

Dewey A, Dean T, Bara A, Lasserson TJ, Walters EH: Chloroquine as a steroid sparing agent for asthma. Cochrane Database of Systematic Reviews. 2003, CD003275-

87.

Powell H, Gibson PG: High dose versus low dose inhaled corticosteroid as initial starting dose for asthma in adults and children. Cochrane Database of Systematic Reviews. 2003

88.

Guevara JP, Ducharme FM, Keren R, Nihtianova S, Zorc J: Inhaled corticosteroids versus sodium cromoglycate in children and adults with asthma. Cochrane Database of Systematic Reviews. 2006, CD003558-

89.

Edmonds ML, Camargo CA, Brenner BE, Rowe BH: Inhaled steroids for acute asthma following emergency department discharge. Cochrane Database of Systematic Reviews. 2000, CD002316-

90.

Mash B, Bheekie A, Jones PW: Inhaled versus oral steroids for adults with chronic asthma. Cochrane Database of Systematic Reviews. 2001, CD002160-

91.

Taramarcaz P, Gibson PG: Intranasal corticosteroids for asthma control in people with coexisting asthma and rhinitis. Cochrane Database of Systematic Reviews. 2003, CD003570-

92.

Evans DJ, Cullinan P, Geddes DM, Walters EH, Milan SJ, Jones PW: Cyclosporin as an oral corticosteroid sparing agent in stable asthma. Cochrane Database of Systematic Reviews. 2000, CD002993-

93.

Adams NP, Bestall JC, Jones PW, Lasserson TJ, Griffiths B, Cates CJ: Fluticasone at different doses for chronic asthma in adults and children. Cochrane Database of Systematic Reviews. 2005, CD003534-

94.

Lasserson TJ, Cates CJ, Jones A-B, Steele EH, White J: Fluticasone versus HFA-beclomethasone dipropionate for chronic asthma in adults and children. Cochrane Database of Systematic Reviews. 2006, CD005309-

95.

Adams N, Bestall JM, Lasserson TJ, Jones PW: Fluticasone versus beclomethasone or budesonide for chronic asthma in adults and children. Cochrane Database of Systematic Reviews. 2005, CD002310-

96.

Adams NP, Bestall JC, Lasserson TJ, Jones PW, Cates CJ: Fluticasone versus placebo for chronic asthma in adults and children. Cochrane Database of Systematic Reviews. 2005, CD003135-

97.

Gibson PG, Henry RL, Coughlan JL: Gastro-oesophageal reux treatment for asthma in adults and children. Cochrane Database of Systematic Reviews. 2003, CD001496-

98.

Evans DJ, Cullinan P, Geddes DM, Walters EH, Milan SJ, Jones PW: Gold as an oral corticosteroid sparing agent in stable asthma. Cochran Database of Systematic Reviews. 2000, CD002985-

99.

Blitz M, Blitz S, Beasely R, Diner BM, Hughes R, Knopp JA, Rowe BH: Inhaled magnesium sulfate in the treatment of acute asthma. Cochrane Database of Systematic Reviews. 2005, CD003898-

100.

Rowe BH, Bretzlaff JA, Bourdon C, Bota GW, Camargo CA: Magnesium sulfate for treating exacerbations of acute asthma in the emergency department. Cochrane Database of Systematic Reviews. 2000, CD001490-

101.

Richeldi L, Ferrara G, Fabbri LM, Lasserson TJ, Gibson PG: Macrolides for chronic asthma. Cochrane Database of Systematic Reviews. 2005, CD002997-

102.

Evans DJ, Cullinan P, Geddes DM, Walters EH, Milan SJ, Jones PW: Troleandomycin as an oral corticosteroid sparing agent in stable asthma. Cochrane Database of Systematic Reviews. 2000, CD002987-

103.

Davies H, Olson L, Gibson P: Methotrexate as a steroid sparing agent for asthma in adults. Cochrane Database of Systematic Reviews. 1998, CD000391-

104.

Hayashi K, Yanagi M, Wood-Baker R, Takamatsu I, Anami K: Oxatomide for stable asthma in adults and children. Cochrane Database of Systematic Reviews. 2003, CD002179-

105.

Petsky HL, Kynaston JA, Turner C, Li AM, Cates CJ, Lasserson TJ, Chang AB: Tailored interventions based on sputum eosinophils versus clinical symptoms for asthma in children and adults. Cochrane Database of Systematic Reviews. 2007, CD005603-

106.

Dewey A, Dean T, Bara A, Lasserson TJ, Walters EH: Colchicine as an oral corticosteroid sparing agent for asthma. Cochrane Database of Systematic Reviews. 2003, CD003273-

107.

Dewey A, Bara A, Dean T, Walters EH: Dapsone as an oral corticosteroid sparing agent for asthma. Cochrane Database of Systematic Reviews. 2002, CD003268-

108.

Ram FSF, Wedzicha JA: Ambulatory oxygen for chronic obstructive pulmonary disease. Cochrane Database of Systematic Reviews. 2008, CD000238-

109.

Jones AP, Rowe BH: Bronchopulmonary hygiene physical therapy for chronic obstructive pulmonary disease and bronchiectasis. Cochrane Database of Systematic Reviews. 1998, CD000045-

110.

Rodrigo G, Pollack C, Rodrigo C, Rowe B, Walters EH: Heliox for treatment of exacerbations of chronic obstructive pulmonarydisease. Cochrane Database of Systematic Reviews. 2001, CD003571-

111.

Nonoyama ML, Brooks D, Lacasse Y, Guyatt GH, Goldstein RS: Oxygen therapy during exercise training in chronic obstructive pulmonary disease. Cochrane Database of Systematic Reviews. 2007, CD005372-

112.

Lacasse Y, Goldstein R, Lasserson TJ, Martin S: Pulmonary rehabilitation for chronic obstructive pulmonary disease. Cochrane Database of Systematic Reviews. 2006, CD003793-

113.

Bradley JM, O'Neill B: Short-term ambulatory oxygen for chronic obstructive pulmonary disease. Cochrane Database of Systematic Reviews. 2005, CD004356-

114.

Geddes EL, Reidb WD, Crowe J, O'Brien K, Brooks D: Inspiratory muscle training in adults with chronic obstructive pulmonary disease: A systematic review. Respir Med. 2005, 99: 1440-1458. 10.1016/j.rmed.2005.03.006.PubMed

115.

Geddes EL, O'Brien K, Reid WD, Brooks D, Crowe J: Inspiratory muscle training in adults with chronic obstructive pulmonary disease: an update of a systematic review. Respir Med. 2008, 102: 1715-1729. 10.1016/j.rmed.2008.07.005.PubMed

116.

Lotters FB, van Tol G, Kwakkel R: Gosselink: Effects of controlled inspiratory muscle training in patients with COPD: a meta-analysis. Eur Respir J. 2002, 20: 570-576. 10.1183/09031936.02.00237402.PubMed

117.

Chavannes N, Vollenberg JJ, van Schayck CP, Wouters EFM: Effects of physical activity in mild to moderate COPD: a systematic review. Br J Gen Pract. 2002, 52: 574-578.PubMedPubMedCentral

118.

Rose C, Wallace L, Dickson R, Ayres J, Lehman R, Searle Y, Burge PS: The most effective psychologically-based treatments to reduce anxiety and panic in patients with chronic obstructive pulmonary disease (COPD): a systematic review. Patient Education and Counselling. 2002, 47 (4): 311-318. 10.1016/S0738-3991(02)00004-6.

119.

van 't Hul A, Kwakkel G, Gosselink R: The Acute Effects of Noninvasive Ventilatory Support During Exercise on Exercise Endurance and Dyspnea in Patients With Chronic Obstructive Pulmonary Disease: A Systematic Review. J Cardiopulm Rehabil. 2002, 22: 290-297.PubMed

120.

Adams SG, Smith PK, Allan PF, Anzueto A, Pugh JA, Cornell JE: Systematic review of the chronic care model in chronic obstructive pulmonary disease prevention and management. Arch Intern Med. 2007, 167 (6): 551-561. 10.1001/archinte.167.6.551.PubMed

121.

O'Neill B, MacMahon J, Bradley J: Short-burst oxygen therapy in chronic obstructive pulmonary disease: Evidence-based review. Respir Med. 2006, 100: 1129-1138.PubMed

122.

Young J, Fry-Smith A, Hyde C: Lung volume reduction surgery (LVRS) for chronic obstructive pulmonary disease (COPD) with underlying severe emphysema. Thorax. 1999, 54: 779-789. 10.1136/thx.54.9.779.PubMedPubMedCentral

123.

Shoemaker MJ, Donker S, LaPoe A: Inspiratory muscle training in patients with chronic obstructive pulmonary disease: the state of the evidence. Cardiopulmon Phy Ther J. 2009, 20 (3): 5-15.

124.

Turnock AC, Walters EH, Walters JAE, Wood-Baker R: Action plans for chronic obstructive pulmonary disease. Cochrane Database of Systematic Reviews. 2005, CD005074-

125.

Cranston JM, Crockett AJ, Moss JR, Alpers JH: Domiciliary oxygen for chronic obstructive pulmonary disease. Cochrane Database of Systematic Reviews. 2005, CD001744-

126.

Smith B, Appleton S, Adams R, Southcott A, Ruf R: Home care by outreach nursing for chronic obstructive pulmonary disease. Cochrane Database of Systematic Reviews. 2001, CD000994-

127.

Ram FSF, Wedzicha JA, Wright J, Greenstone M: Hospital at home for acute exacerbations of chronic obstructive pulmonary disease. Cochrane Database of Systematic Reviews. 2003, CD003573-

128.

Wijkstra PJ, Lacasse Y, Guyatt GH, Goldstein RS: Nocturnal non-invasive positive pressure ventilation for stable chronic obstructive pulmonary disease. Cochrane Database of Systematic Reviews. 2002, CD002878-

129.

Ferreira IM, Brooks D, Lacasse Y, Goldstein RS, White J: Nutritional supplementation for stable chronic obstructive pulmonary disease. Cochrane Database of Systematic Reviews. 2005, CD000998-

130.

Ram FSF, Brocklebank DM, Muers M, Wright J, Jones PW: Pressurised metered-dose inhalers versus all other hand-held inhalers devices to deliver bronchodilators for chronic obstructive pulmonary disease. Cochrane Database of Systematic Reviews. 2002, CD002170-

131.

Salman GF, Mosier MC, Beasley BW, Calkins DR: Rehabilitation for patients with chronic obstructive pulmonary disease: meta-analysis of randomised controlled trials. J Gen Intern Med. 2003, 18 (3): 213-221. 10.1046/j.1525-1497.2003.20221.x.PubMedPubMedCentral

132.

Monninkhof EM, van der Valk PDLPM, van der Palen J, van Herwaarden CLA, Partidge MR, Walters EH, Zielhuis GA: Self management education for chronic obstructive pulmonary disease. Cochrane Database of Systematic Reviews. 2002, CD002990-

133.

Austin M, Wood-Baker R: Oxygen therapy in the pre-hospital setting for acute exacerbations of chronic obstructive pulmonary disease. Cochrane Database of Systematic Reviews. 2006, CD005534-

134.

Ram FSF, Picot J, Lightowler J, Wedzicha JA: Non-invasive positive pressure ventilation for treatment of respiratory failure due to exacerbations of chronic obstructive pulmonary disease. Cochrane Database of Systematic Reviews. 2004, CD004104-

135.

McCrory DC, Brown CD: Anticholinergic bronchodilators versus beta2-sympathomimetic agents for acute exacerbations of chronic obstructive pulmonary disease. Cochrane Database of Systematic Reviews. 2003, CD003900-

136.

Nannini L, Cates CJ, Lasserson TJ, Poole P: Combined corticosteroid and longacting beta-agonist in one inhaler for chronic obstructive pulmonary disease. Cochrane Database of Systematic Reviews. 2004, CD003794-

137.

Poole PJ, Chacko E, Wood-Baker RWB, Cates CJ: Influenza vaccine for patients with chronic obstructive pulmonary disease. Cochrane Database of Systematic Reviews. 2006, CD002733-

138.

Brown CD, McCrory D, White J: Inhaled short-acting beta2-agonists versus ipratropium for acute exacerbations of chronic obstructive pulmonary disease. Cochrane Database of Systematic Reviews. 2001, CD002984-

139.

Granger R, Walters J, Poole PJ, Lasserson TJ, Mangtani P, Cates CJ, Wood-Baker R: Injectable vaccines for preventing pneumococcal infection in patients with chronic obstructive pulmonary disease. Cochrane Database of Systematic Reviews. 2006, CD001390-

140.

Appleton S, Jones T, Poole P, Pilotto L, Adams R, Lasserson TJ, Smith B, Muhammad J: Ipratropium bromide versus long acting beta-2 agonists for stable chronic obstructive pulmonary disease. Cochrane Database of Systematic Reviews. 2006, CD006101-

141.

Appleton S, Jones T, Poole P, Pilotto L, Adams R, Lasserson TJ, Smith B, Muhammad J: Ipratropium bromide versus short acting beta-2 agonists for stable chronic obstructive pulmonary disease. Cochrane Database of Systematic Reviews. 2006, CD001387-

142.

Appleton S, Poole P, Smith B, Veale A, Lasserson TJ, Chan MM, Cates CJ: Long-acting beta2-agonists for poorly reversible chronic obstructive pulmonary disease. Cochrane Database of Systematic Reviews. 2006, CD001104-

143.

Walters JAE, Walters EH, Wood-Baker R: Oral corticosteroids for stable chronic obstructive pulmonary disease. Cochrane Database of Systematic Reviews. 2005, CD005374-

144.

Ram FSF, Jones PW, Castro AA, de Brito Jardim JR, Atallah AN, Lacasse Y, Mazzini R, Goldstein R, Cendon S: Oral theophylline for chronic obstructive pulmonary disease. Cochrane Database of Systematic Reviews. 2002, CD003902-

145.

Sestini P, Renzoni E, Robinson S, Poole P, Ram FSF: Short-acting beta2-agonists for stable chronic obstructive pulmonary disease. Cochrane Database of Systematic Reviews. 2002, CD001495-

146.

Wood-Baker RR, Gibson PG, Hannay M, Walters EH, Walters JAE: Systemic corticosteroids for acute exacerbations of chronic obstructive pulmonary disease. Cochrane Database of Systematic Reviews. 2005, CD001288-

147.

Barr RG, Bourbeau J, Camargo CA, Ram FSF: Tiotropium for stable chronic obstructive pulmonary disease: a meta-analysis. Thorax. 2006, 61: 854-862, July 2006. 10.1136/thx.2006.063271.PubMedPubMedCentral

148.

Liesker JJW, Wijkstra PJ, Ten Hacken NHT, Keoter GH, Postma DS, Kerstjens HAM: A systematic review of the effects of bronchodilators on exercise capacity in patients with COPD. Chest. 2002, 121: 597-608. 10.1378/chest.121.2.597.PubMed

149.

Husereau D, Shukla V, Boucher M, Mensinkai S, Dales R: Long acting β2 agonists for stable chronic obstructive pulmonary disease with poor reversibility: a systematic review of randomised controlled trials. BMC Pulm Med. 2004, 4: 7-10.1186/1471-2466-4-7.PubMedPubMedCentral

150.

Yang IA, Fong KM, Sim EHA, Black PN, Lasserson TJ: Inhaled corticosteroids for stable chronic obstructive pulmonary disease. Cochrane Database of Systematic Reviews. 2007, CD002991-

151.

Barr RG, Rowe BH, Camargo CA: Methylxanthines for exacerbations of chronic obstructive pulmonary disease. Cochrane Database of Systematic Reviews. 2003, CD002168-Art. No CD002168, 2

152.

Poole PJ, Black PN: Mucolytic agents for chronic bronchitis or chronic obstructive pulmonary disease. Cochrane Database of Systematic Reviews. 2006, CD001287-

153.

Jennings A-L, Davies , Higgins JPT, Gibbs JSR, Broadley KE: A systematic review of the use of opioids in the management of dyspnoea. Thorax. 2002, 57: 939-944. 10.1136/thorax.57.11.939.PubMedPubMedCentral

154.

French J, Bilton D, Campbell F: Nurse specialist care for Bronchiectasis. Cochrane Database of Systematic Reviews. 2003, CD004359-

155.

Bradley J, Moran F, Greenstone M: Physical training for bronchiectasis. Cochrane Database of Systematic Reviews. 2002, CD002166-

156.

Wills P, Greenstone M: Inhaled hyperosmolar agents for bronchiectasis (Review). Cochrane Database of Systematic Reviews. 2006

157.

Ram FSF, Wells A, Kolbe J: Inhaled steroids for bronchiectasis. Cochrane Database of Systematic Reviews. 2000, CD000996-

158.

Crockett AJ, Cranston JM, Latimer KM, Alpers JH: Mucolytics for bronchiectasis. Cochrane Database of Systematic Reviews. 2001, CD001289-

159.

Evans DJ, Bara AI, Greenstone M: Prolonged antibiotics for purulent bronchiectasis in children and adults. Cochrane Database of Systematic Reviews. 2007, CD001392-

160.

Steele K, Lasserson JA, Greenstone M: Oral methylxanthines for bronchiectasis. Cochrane Database of Systematic Reviews. 2000, CD002734-

161.

Sheikh A, Nolan D, Greenstone M: Long-acting beta2-agonists for bronchiectasis. Cochrane Database of Systematic Reviews. 2001, CD002155-

162.

Franco F, Sheikh A, Greenstone M: Short acting beta2-agonists for bronchiectasis. Cochrane Database of Systematic Reviews. 2003, CD003572-

163.

Lasserson TJ, Holt K, Evans D, Milan SJ, Greenstone M: Anticholinergic therapy for bronchiectasis. Cochrane Database of Systematic Reviews. 2001, CD002163-

164.

Corless JA, Warburton CJ: Leukotriene receptor antagonists for non-cystic fibrosis bronchiectasis. Cochrane Database of Systematic Reviews. 2000, CD002174-

165.

Lasserson TJ, Holt K, Milan SJ, Greenstone M: Oral steroids for bronchiectasis (stable and acute exacerbations). Cochrane Database of Systematic Reviews. 2001, CD002162-

166.

Chang CC, Singleton RJ, Morris PS, Chang AB: Pneumococcal vaccines for children and adults with bronchiectasis. Cochrane Database of Systematic Reviews. 2007, CD006316-

167.

Davies HR, Richeldi L, Walters EH: Immunomodulatory agents for idiopathic pulmonary fibrosis. Cochrane Database of Systematic Reviews, D003134. 2003, CD003134-

168.

Paramothayan S, Lasserson TJ, Walters EH: Immunosuppressive and cytotoxic therapy for pulmonary sarcoidosis. Cochrane Database of Systematic Reviews. 2006, CD003536-

169.

Polosa R, Simidchiev A, Walters EH: Nebulised morphine for severe interstitial lung disease. Cochrane Database of Systematic Reviews. 2002, CD002872-

170.

Paramothayan NS, Lasserson TJ, Jones PW: Corticosteroids for pulmonary sarcoidosis. Cochrane Database of Systematic Reviews. 2005, CD001114-

171.

Richeldi L, Davies HR, Ferrara G, Franco F: Corticosteroids for idiopathic pulmonary fibrosis. Cochrane Database of Systematic Reviews. 2003, CD002880-

172.

Staykova T, Black P, Chacko E, Ram FSF, Poole P: Prophylactic antibiotic therapy for chronic bronchitis. Cochrane Database of Systematic Reviews. 2001, CD004105-

173.

Spooner CH, Spooner GR, Rowe BH: Mast-cell stabilising agents to prevent exercise-induced broncho-constriction. Cochrane Database of Systematic Reviews. 2003, CD002307-

174.

Spooner CH, Saunders LD, Rowe BH: Nedocromil sodium for preventing exercise-induced broncho-constriction. Cochrane Database of Systematic Reviews. 2002, CD001183-

175.

Kelly K, Spooner CH, Rowe BH: Nedocromil sodium versus sodium cromoglycate for preventing exercise-induced broncho-constriction in asthmatics. Cochrane Database of Systematic Reviews. 2000, CD002731-

176.

Liu C, Chen J: Endothelin receptor antagonists for pulmonary arterial hypertension. Cochrane Database of Systematic Reviews. 2006, CD004434-

177.

Paramothayan NS, Lasserson TJ, Wells AU, Walters EH: Prostacyclin for pulmonary hypertension in adults. Cochrane Database of Systematic Reviews. 2005, CD002994-

178.

Kanthapillai P, Lasserson TJ, Walters EH, Sildena l: Sildenafil for pulmonary hypertension. Cochrane Database of Systematic Reviews. 2004, CD003562-

179.

Reid WD, Geddes EL, O'Brien K, Brooks D, Crowe J: Effects of inspiratory muscle training in cystic fibrosis. Clin Rehabil. 2008, 22: 1003-1013. 10.1177/0269215508090619.PubMed

180.

Asthma UK: Where do we stand? Asthma in the UK today. London, Asthma UK. 2004

181.

Smith NM: The 'needs of people with asthma' survey and initial presentation of the data. Asthma Journal. 2000, 5: 133-7.

182.

World Health Organisation: World Health Statistics. 2008, [http://www.who.int/whosis/whostat/EN_WHS08_Full.pdf]

183.

Lutz S, Norell R, Bertucio C, Kachnic L, Johnson C, Arthur D: Symptom frequency and severity in patients with metastatic or locally recurrent lung cancer: a prospective study using the lung cancer symptom scale in a community hospital. Journal of Palliative Medicine. 2001, 4 (2): 157-65. 10.1089/109662101750290191.PubMed

184.

Booth S, Bausewein C, Higginson I, Moosavi SH: Pharmacological treatment of refractory breathlessness. Expert Rev Resp Med. 2009, 3 (1): 21-36. 10.1586/17476348.3.1.21.

185.

Solano JP, Gomes B, Higginson IJ: A Comparison of Symptom Prevalence in Far Advanced Cancer, AIDS, Heart Disease, Chronic Obstructive Pulmonary Disease and Renal Disease. J Pain Symptom Manage. 2006, 31 (1): 58-69. 10.1016/j.jpainsymman.2005.06.007.PubMed

186.

Scano G, Stendardi L, Grazzini M: Understanding Dyspnoea by its language. Eur Respir J. 2005, 25: 380-385. 10.1183/09031936.05.00059404.PubMed

187.

Coli C, Picariello M, Stendardi L Grazzini M, Binazzi B, Duranti R, Scano G: Is there a link between the qualitative descriptors and the quantitative perception of dyspnoea in asthma?. Chest. 2002, 130: 1072-1081.

188.

Yorke J, Moosavi SH, Shuldham C, Jones PW: Quantification of dyspnoea using descriptors: development and initial testing of the Dyspnoea-12. Thorax. 2010, 65: 21-26. 10.1136/thx.2009.118521.PubMed

189.

Bausewein C, Farquhar M, Booth S, Gysels , Higgins IJ: Measurement of breathlessness in advanced disease: a systematic review. Resp Med. 2007, 101: 339-410. 10.1016/j.rmed.2006.07.003.

190.

Bestall JC, Paul EA, Garrod R, Garnham R, Jones PW, Wedzicha JA: Usefulness of the Medical Research Council (MRC) dyspnoea scale as a measure of disability in patients with chronic obstructive pulmonary disease. Thorax. 1999, 54: 581-586. 10.1136/thx.54.7.581.PubMedPubMedCentral

191.

Mahler DA, Selecky PA, Harrod CG, Benditt JO, Carrieri-Kohlman V, Curtis JR, Manning HL, Mularski RA, Varkey B, Campbell M, Carter ER, Chiong JR, Ely EW, Hansen-Flaschen J, O'Donnell DE, Waller A: Consensus statement on the management of dyspnea in patients with advanced lung or heart disease. Chest. 2010, 137: 674-691. 10.1378/chest.09-1543.PubMed

The pre-publication history for this paper can be accessed here:http://www.biomedcentral.com/1471-2466/10/63/prepub

Title: An integrative review of systematic reviews related to the management of breathlessness in respiratory illnesses
Authors: Chris D Bailey
Richard Wagland
Rasha Dabbour
Ann Caress
Jaclyn Smith
Alex Molassiotis
Publication date: 01-12-2010
Publisher: BioMed Central
Published in: BMC Pulmonary Medicine / Issue 1/2010
Electronic ISSN: 1471-2466
DOI: https://doi.org/10.1186/1471-2466-10-63

ACC 2024 Congress Coverage

Heart Failure Video

Keynote webinar | Spotlight on sleep in brain health

Springer Medicine

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

Abstract

Background

Methods

Results

Conclusions

ACC 2024 Congress Coverage

Year in Review: Heart failure and cardiomyopathies

Semaglutide benefits people with type 2 diabetes and obesity-related heart failure

Incentivised to exercise

New intervention for STEMI-related cardiogenic shock

» View more highlights on the ACC 2024 congress hub page

Keynote webinar | Spotlight on sleep in brain health

Springer Medicine

Abstract

Background

Methods

Results

Conclusions

Please log in to get access to this content

Other articles of this Issue 1/2010

Mechanical ventilation modulates Toll-like receptor-3-induced lung inflammation via a MyD88-dependent, TLR4-independent pathway: a controlled animal study

Improved adherence with once-daily versus twice-daily dosing of mometasone furoate administered via a dry powder inhaler: a randomized open-label study

Random variation of inspiratory lung function parameters in patients with COPD: a diagnostic accuracy study

Imipenem resistance of Pseudomonas in pneumonia: a systematic literature review

A phase 1 study evaluating the pharmacokinetics, safety and tolerability of repeat dosing with a human IL-13 antibody (CAT-354) in subjects with asthma

Association of FcγRIIa R131H polymorphism with idiopathic pulmonary fibrosis severity and progression

ACC 2024 Congress Coverage

Year in Review: Heart failure and cardiomyopathies

Semaglutide benefits people with type 2 diabetes and obesity-related heart failure

Incentivised to exercise

New intervention for STEMI-related cardiogenic shock

» View more highlights on the ACC 2024 congress hub page