Understanding persistent breathlessness: impact on patients and optimal approaches to symptomatic reduction - an overview.

IF 2.9 3区 医学 Q2 RESPIRATORY SYSTEM Expert Review of Respiratory Medicine Pub Date : 2023-05-01 DOI:10.1080/17476348.2023.2208348
Diana H Ferreira, Slavica Kochovska, Vanessa N Brunelli, David C Currow
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Abstract

Introduction: Persistent breathlessness (breathlessness persisting despite optimal treatment for the underlying condition and resulting in disability) is a prevalent syndrome associated with chronic and life-limiting conditions. Improving the clinical recognition and assessment of persistent breathlessness is essential to ensure people are provided with the best treatment for optimal symptom control.

Areas covered: This overview focuses on the impact of persistent breathlessness on patients, carers and the health system. It highlights the importance of identifying persistent breathlessness in clinical consultations, suggests steps to recognize this syndrome and discusses the evidence for non-pharmacological and pharmacological treatments in this context. Future research directions are also suggested.

Expert opinion: Persistent breathlessness is often invisible because 1) people may not engage with the health system and 2) both clinicians and patients are reluctant to discuss breathlessness in clinical consultations. Improving the recognition and assessment of this syndrome is critical to facilitate meaningful conversations between patients and clinicians and ensure patient-centered care. Non-pharmacological strategies are key to improving symptom management and health outcomes. Regular, low-dose, sustained-release morphine may help further reduce breathlessness in people who remain symptomatic despite disease-specific and non-pharmacological therapies.

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理解持续性呼吸困难:对患者的影响和减轻症状的最佳方法-概述。
简介:持续性呼吸困难(尽管对基础疾病进行了最佳治疗,但仍持续呼吸困难并导致残疾)是一种与慢性和限制性疾病相关的普遍综合征。改善对持续性呼吸困难的临床识别和评估对于确保为患者提供最佳治疗以实现最佳症状控制至关重要。涵盖领域:本概述侧重于持续性呼吸困难对患者、护理人员和卫生系统的影响。它强调了在临床咨询中识别持续性呼吸困难的重要性,提出了识别这种综合征的步骤,并讨论了在这种情况下非药物和药物治疗的证据。并提出了今后的研究方向。专家意见:持续的呼吸困难通常是看不见的,因为1)人们可能不参与卫生系统,2)临床医生和患者都不愿意在临床咨询中讨论呼吸困难。提高对这种综合征的认识和评估对于促进患者和临床医生之间有意义的对话以及确保以患者为中心的护理至关重要。非药物策略是改善症状管理和健康结果的关键。常规的、低剂量的、持续释放的吗啡可能有助于进一步减少那些尽管有疾病特异性和非药物治疗仍有症状的人的呼吸困难。
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来源期刊
CiteScore
6.80
自引率
2.60%
发文量
90
期刊介绍: Coverage will include the following key areas: - Prospects for new and emerging therapeutics - Epidemiology of disease - Preventive strategies - All aspects of COPD, from patient self-management to systemic effects of the disease and comorbidities - Improved diagnostic methods, including imaging techniques, biomarkers and physiological tests. - Advances in the treatment of respiratory infections and drug resistance issues - Occupational and environmental factors - Progress in smoking intervention and cessation methods - Disease and treatment issues for defined populations, such as children and the elderly - Respiratory intensive and critical care - Updates on the status and advances of specific disease areas, including asthma, HIV/AIDS-related disease, cystic fibrosis, COPD and sleep-disordered breathing morbidity
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