None listed
Conditions
Brief summary
Many people with lung and heart conditions have persistent breathlessness, even when they are receiving the best possible medical care for their condition. Breathlessness Intervention Services have been shown to reduce people’s distress and improve their confidence to manage breathlessness in the UK and Canada but so far these services have not been studied or made available in South Australia. This study will evaluate the feasibility and outcomes of a home-based brief intervention for people with chronic breathlessness due to lung or heart conditions, involving 2-4 visits and 3-4 telephone contacts for assessment and therapy by nurse and physiotherapist using non-drug, evidence-based symptom management therapies that fit the patient’s needs.
Interventions
Participation in a brief intervention based on existing clinical research evidence, directed toward reducing the impact of breathlessness by helping the person to better manage their symptoms. The interventions delivered will not impact on their usual care provided and will be an addition to care once they have been medically and pharmacologically optimised. This brief intervention will involve 2-4 home-based or clinic visits (over the first 4 weeks) from a physiotherapist or nurse and 3-4 telep
Participation in a brief intervention based on existing clinical research evidence, directed toward reducing the impact of breathlessness by helping the person to better manage their symptoms. The interventions delivered will not impact on their usual care provided and will be an addition to care once they have been medically and pharmacologically optimised. This brief intervention will involve 2-4 home-based or clinic visits (over the first 4 weeks) from a physiotherapist or nurse and 3-4 telephone contacts (over the next 4 weeks) by the same clinicians. The timing and number of these visits will be flexible within this time frame based on participant need and collaboration between participants and clinician. Visits are anticipated to be conducted in the participant's home unless they have a preference for clinic visits. The visits will involve comprehensive assessment, collaborative goal setting and therapy using non-drug, symptom management-based therapies that fit the patient’s needs in line with existing evidence (eg Brighton LJ et al Thorax 2018;0:1–12. doi:10.1136/thoraxjnl-2018-211589; Booth S et al Managing breathlessness in clinical practice, Springer Verlag, London 2014) The specific evidence-based therapies that will be delivered help people manage breathlessness by addressing issues related to breathing (examples include hand-held fan, breathing techniques, body position) thinking (action plan for breathlessness, cognitive behavioural therapy strategies; relaxation techniques) and functioning (exercise plan using pedometer; walking aids; activity pacing). The intervention will also include care coordination, facilitation of self-management and integration with all other health and community service providers.
Sponsors
Kylie Johnston
Study design
Allocation
Non-randomised trial
Primary purpose
Treatment
Eligibility
Sex/Gender
All
Age
18 Years to No maximum
Healthy volunteers
No
Inclusion criteria
At SALHN: Diagnosis of chronic obstructive pulmonary disease (COPD) OR diagnosis of heart failure with chronic respiratory comorbidity (eg COPD / asthma / bronchiectasis / suppurative lung disease / interstitial lung disease). At CAHLN: Diagnosed chronic lung condition. - Minimum of 1 admission for an acute exacerbation in the past 12 months - Lives within the SALHN/CALHN demographic area - Troubled by breathlessness in spite of optimal medical and pharmacological treatment for underlying condition. -Stable condition (at least 4 weeks after discharge from hospital) at the time commences pilot study
Exclusion criteria
Patients receiving case management from other existing programs Patients receiving end-stage Palliative Care Services
Outcome results
None listed