Characterizing episodic breathlessness in patients with advanced disease.
BACKGROUND
Episodic 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.


OBJECTIVE
The aim of this study was to determine the duration, severity, frequency and timing of breathlessness episodes in patients with advanced diseases.


METHODS
Explorative 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).


RESULTS
One 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.


CONCLUSIONS
Our 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.
1 Department of Palliative Medicine, Center of Integrated Oncology (BMBF O1KN1106), Cologne/Bonn and Clinical Trials Unit, University Hospital of Cologne , Cologne, Germany .
Vera
V
Weingärtner
Claudia
C
Bausewein
Irene J
IJ
Higginson
Christine
C
Scheve
Fliss E M
FE
Murtagh
Raymond
R
Voltz
Steffen T
ST
Simon
D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D003430:Cross-Sectional Studies; D004417:Dyspnea / Q000503:physiopathology*; D005260:Female; D006333:Heart Failure / Q000503:physiopathology; D006801:Humans; D007407:Interviews as Topic; D008175:Lung Neoplasms / Q000503:physiopathology; D008297:Male; D008875:Middle Aged; D016472:Motor Neuron Disease / Q000503:physiopathology; D029424:Pulmonary Disease, Chronic Obstructive / Q000503:physiopathology; D012720:Severity of Illness Index; D013997:Time Factors