Abstract:
BACKGROUND:Breathlessness is a common and distressing symptom affecting many patients with advanced disease both from malignant and non-malignant origin. A combination of pharmacological and non-pharmacological measures is necessary to treat this symptom successfully. Breathlessness services in various compositions aim to provide comprehensive care for patients and their carers by a multiprofessional team but their effectiveness and cost-effectiveness have not yet been proven. The Breathlessness Support Service (BSS) is a newly created multiprofessional and interdisciplinary outpatient service at a large university hospital in South East London. The aim of this study is to develop and evaluate the effectiveness and cost effectiveness of this multidisciplinary out-patient BSS for the palliation of breathlessness, in advanced malignant and non-malignant disease. METHODS:The BSS was modelled based on the results of qualitative and quantitative studies, and systematic literature reviews. A randomised controlled fast track trial (RCT) comprising two groups: 1) intervention (immediate access to BSS in addition to standard care); 2) control group (standard best practice and access to BSS after a waiting time of six weeks). Patients are included if suffering from breathlessness on exertion or at rest due to advanced disease such as cancer, chronic obstructive pulmonary disease (COPD), chronic heart failure (CHF), interstitial lung disease (ILD) or motor neurone disease (MND) that is refractory to maximal optimised medical management. Both quantitative and qualitative outcomes are assessed in face to-face interviews at baseline, after 6 and 12 weeks. The primary outcome is patients' improvement of mastery of breathlessness after six weeks assessed on the Chronic Respiratory Disease Questionnaire (CRQ). Secondary outcomes for patients include breathlessness severity, symptom burden, palliative care needs, service use, and respiratory measures (spirometry). For analyses, the primary outcome, mastery of breathlessness after six weeks, will be analysed using ANCOVA. Selection of covariates will depend on baseline differences between the groups. Analyses of secondary outcomes will include patients' symptom burden other than breathlessness, physiological measures (lung function, six minute walk distance), and caregiver burden. DISCUSSION:Breathlessness services aim to meet the needs of patients suffering from this complex and burdensome symptom and their carers. The newly created BSS is different to other current services as it is run in close collaboration of palliative medicine and respiratory medicine to optimise medical care of patients. It also involves professionals from various medical, nursing, physiotherapy, occupational therapy and social work background. TRIAL REGISTRATION:ClinicalTrials.gov (NCT01165034).
journal_name
BMC Pulm Medjournal_title
BMC pulmonary medicineauthors
Bausewein C,Jolley C,Reilly C,Lobo P,Kelly J,Bellas H,Madan P,Panell C,Brink E,De Biase C,Gao W,Murphy C,McCrone P,Moxham J,Higginson IJdoi
10.1186/1471-2466-12-58subject
Has Abstractpub_date
2012-09-19 00:00:00pages
58issn
1471-2466pii
1471-2466-12-58journal_volume
12pub_type
杂志文章,随机对照试验abstract:BACKGROUND:Chronic obstructive pulmonary disease (COPD) is hallmarked by inflammatory processes and a progressive decline of lung function. YKL-40 is a potential biomarker of inflammation and mortality in patients suffering from inflammatory lung disease, but its prognostic value in patients with COPD remains unknown. ...
journal_title:BMC pulmonary medicine
pub_type: 临床试验,杂志文章
doi:10.1186/1471-2466-13-77
更新日期:2013-12-30 00:00:00
abstract:BACKGROUND:Alveolar volume measured according to the American Thoracic Society-European Respiratory Society (ATS-ERS) guidelines during the single breath diffusion test can be underestimated when there is maldistribution of ventilation. Therefore, the alveolar volume calculated by taking into account the ATS-ERS guidel...
journal_title:BMC pulmonary medicine
pub_type: 临床试验,杂志文章
doi:10.1186/1471-2466-7-18
更新日期:2007-12-19 00:00:00
abstract:BACKGROUND:A recent method determines regional gas flow of the lung by electrical impedance tomography (EIT). The aim of this study is to show the applicability of this method in a porcine model of mechanical ventilation in healthy and diseased lungs. Our primary hypothesis is that global gas flow measured by EIT can b...
journal_title:BMC pulmonary medicine
pub_type: 杂志文章
doi:10.1186/1471-2466-14-73
更新日期:2014-04-29 00:00:00
abstract:BACKGROUND:Beginning at a young age, children with cystic fibrosis (CF) embark on demanding care regimens that pose challenges to parents. We examined the extent to which clinical, demographic and psychosocial features inform patterns of adherence to pulmonary therapies and how these patterns can be used to develop cli...
journal_title:BMC pulmonary medicine
pub_type: 杂志文章
doi:10.1186/s12890-020-01202-x
更新日期:2020-06-18 00:00:00
abstract:BACKGROUND:Anti-tuberculosis therapy requires at least six-month treatment with continuous administration of combined antibiotics, including isoniazid, rifampicin, pyrazinamide, and ethambutol. The long-term exposure to antibiotics could cause consequent changes in gut microbiota, which may alter the gastrointestinal f...
journal_title:BMC pulmonary medicine
pub_type: 杂志文章,多中心研究
doi:10.1186/s12890-019-0981-9
更新日期:2019-11-11 00:00:00
abstract:BACKGROUND:Smoking cessation is the best possible way to prevent the progression of smoking related airway diseases. However, the effect and time scale of smoking cessation on airway inflammation/remodelling are largely unknown. This prospective study evaluated the effects of smoking cessation on induced sputum (IS) ne...
journal_title:BMC pulmonary medicine
pub_type: 杂志文章
doi:10.1186/1471-2466-10-13
更新日期:2010-03-14 00:00:00
abstract:BACKGROUND:CHCHD2 was identified a novel cell migration-promoting gene, which could promote cell migration and altered cell adhesion when ectopically overexpressed in NIH3T3 fibroblasts, and it was identified as a protein necessary for OxPhos function as well. However, the clinic relevance of CHCHD2 expression in NSCLC...
journal_title:BMC pulmonary medicine
pub_type: 杂志文章
doi:10.1186/s12890-020-1079-0
更新日期:2020-02-13 00:00:00
abstract:BACKGROUND:A variety of large randomized controlled trials (RCT's) evaluating pharmacotherapy in chronic obstructive pulmonary disease (COPD) patients does exist. One of the drugs that has been tested is the new long-acting anticholinergic glycopyrronium bromide. METHODS:As the generalizability of results from RCT's i...
journal_title:BMC pulmonary medicine
pub_type: 杂志文章,多中心研究,随机对照试验
doi:10.1186/1471-2466-15-2
更新日期:2015-01-12 00:00:00
abstract:BACKGROUND:Very few data exist on the management of community-acquired pneumonia (CAP) in patients admitted to hospitals in the Gulf region. The objectives of this study were to describe treatment patterns for CAP in 38 hospitals in five Gulf countries (United Arab Emirates, Kuwait, Bahrain, Oman, and Qatar) and to com...
journal_title:BMC pulmonary medicine
pub_type: 杂志文章
doi:10.1186/s12890-015-0108-x
更新日期:2015-09-30 00:00:00
abstract:BACKGROUND:Selection bias is a systematic error in epidemiologic studies that may seriously distort true measures of associations between exposure and disease. Observational studies are highly susceptible to selection bias, and researchers should therefore always examine to what extent selection bias may be present in ...
journal_title:BMC pulmonary medicine
pub_type: 杂志文章
doi:10.1186/1471-2466-14-63
更新日期:2014-04-16 00:00:00
abstract:BACKGROUND:Skeletal muscle function dysfunction has been reported in patients with cystic fibrosis (CF). Studies so far showed inconclusive data whether reduced exercise capacity is related to intrinsic muscle dysfunction in CF. METHODS:Twenty patients with CF and 23 age-matched controls completed an incremental cardi...
journal_title:BMC pulmonary medicine
pub_type: 杂志文章
doi:10.1186/s12890-019-1039-8
更新日期:2019-12-30 00:00:00
abstract:BACKGROUND:Exposure to perinatal anxiety affects disease susceptibility in offspring but studies on the association between perinatal anxiety and gene polymorphisms are lacking. This study aimed to elucidate the interaction between perinatal anxiety and polymorphisms in antioxidant defense and innate immunity genes on ...
journal_title:BMC pulmonary medicine
pub_type: 杂志文章
doi:10.1186/1471-2466-14-154
更新日期:2014-09-29 00:00:00
abstract:BACKGROUND:The flow-volume (FV) curve pattern in the pulmonary function test (PFT) for obstructive lung diseases is widely recognized. However, there are few reports on FV curve pattern in idiopathic pulmonary fibrosis (IPF). In this study, we investigated the relationship between FV curve pattern and clinical or radio...
journal_title:BMC pulmonary medicine
pub_type: 杂志文章
doi:10.1186/s12890-020-01254-z
更新日期:2020-08-12 00:00:00
abstract:BACKGROUND:Although many studies on people with Chronic Obstructive Pulmonary Disease (COPD) have examined the mutual impact of physical status and emotional experience, there is limited knowledge about the way COPD people first-hand perceive their condition. This study was designed to investigate the illness perceptio...
journal_title:BMC pulmonary medicine
pub_type: 杂志文章
doi:10.1186/s12890-020-1157-3
更新日期:2020-05-04 00:00:00
abstract:BACKGROUND:Chronic obstructive pulmonary disease (COPD) with carbon dioxide retention is associated with a worsening clinical condition and the beginning of pulmonary ventilation decompensation. This study aimed to identify the factors associated with carbon dioxide retention. METHODS:This was a retrospective study of...
journal_title:BMC pulmonary medicine
pub_type: 杂志文章
doi:10.1186/s12890-018-0691-8
更新日期:2018-07-31 00:00:00
abstract:BACKGROUND:Irisin, a recently discovered myokine, is assumed to be secreted by muscle cells in response to exercise and is involved in the regulation of energy metabolism by browning white adipose tissue cells. However, due to the fact that previous studies revealed conflicting results concerning the association betwee...
journal_title:BMC pulmonary medicine
pub_type: 杂志文章
doi:10.1186/s12890-015-0035-x
更新日期:2015-04-22 00:00:00
abstract:BACKGROUND:Pulmonary surfactant D (SP-D) has important regulatory functions for innate immunity and has been implicated as a biomarker for chronic obstructive pulmonary disease (COPD). We hypothesized that COPD patients would have reduced bronchoalveolar lavage (BAL) fluid SP-D levels compared to healthy smoking and no...
journal_title:BMC pulmonary medicine
pub_type: 杂志文章
doi:10.1186/1471-2466-10-53
更新日期:2010-10-25 00:00:00
abstract:BACKGROUND:Neurohumoral activation is present in COPD and might provide a link between pulmonary and systemic effects, especially cardiovascular disease. Because long acting inhaled β-agonists reduce hyperinflation, they could reduce sympathoexcitation by improving the inflation reflex. We aimed to evaluate if inhaled ...
journal_title:BMC pulmonary medicine
pub_type: 临床试验,杂志文章
doi:10.1186/s12890-015-0054-7
更新日期:2015-04-30 00:00:00
abstract:BACKGROUND:Asthma is a common chronic disease among young adults, and several studies have reported increased mortality rates in patients with asthma. However, no study has described sudden unexpected death in a nationwide setting in patients with uncontrolled asthma. We defined uncontrolled asthma as a previous hospit...
journal_title:BMC pulmonary medicine
pub_type: 杂志文章
doi:10.1186/s12890-015-0033-z
更新日期:2015-04-14 00:00:00
abstract:BACKGROUND:The Darlington and Northallerton Asthma Study is an observational cohort study started in 1983. At that time little was published about long term outcome in asthma and the contribution of change in reversible disease or airway remodelling to any excess deterioration in function. The study design included reg...
journal_title:BMC pulmonary medicine
pub_type: 杂志文章
doi:10.1186/1471-2466-5-2
更新日期:2005-01-31 00:00:00
abstract:BACKGROUND:The lung-protective ventilation bundle has been shown to reduce mortality in adult acute respiratory distress syndrome (ARDS). This concept has expanded to other areas of acute adult ventilation and is recommended for pediatric ventilation. A component of lung-protective ventilation relies on a prediction of...
journal_title:BMC pulmonary medicine
pub_type: 杂志文章
doi:10.1186/s12890-017-0427-1
更新日期:2017-05-23 00:00:00
abstract:BACKGROUND:In adults, overweight is associated with reduced lung function, in children evidence on this association is conflicting. We examined the association of body mass index (BMI) and waist circumference (WC) at age 12, and of persistently (at ages 8 and 12 years) high BMI and large WC, with forced vital capacity ...
journal_title:BMC pulmonary medicine
pub_type: 杂志文章
doi:10.1186/s12890-015-0032-0
更新日期:2015-04-22 00:00:00
abstract:BACKGROUND:During the last few years, investigators have debated the role that infectious agents may have in sarcoidosis pathogenesis. With the emergence of new molecular biology techniques, several studies have been conducted; therefore, we performed a meta-analysis in order to better explain this possible association...
journal_title:BMC pulmonary medicine
pub_type: 杂志文章,meta分析,评审
doi:10.1186/s12890-016-0332-z
更新日期:2016-11-28 00:00:00
abstract:BACKGROUND:We have previously shown that diabetic rats are more susceptible to sepsis, but that the Acute lung injury (ALI) secondary to sepsis is less intense than in non-diabetics. In the present study, we further investigated the ALI-secondary to sepsis in diabetic rats and the effect of insulin treatment. METHODS:...
journal_title:BMC pulmonary medicine
pub_type: 杂志文章
doi:10.1186/1471-2466-14-177
更新日期:2014-11-15 00:00:00
abstract:BACKGROUND:Subcutaneous treprostinil is a prostacyclin analogue used to treat pulmonary arterial hypertension (PAH). Due to local pain it can cause a deterioration of heart related quality of life (HRQoL) or even abandonment of treatment. The aim of this paper was to assess the feasibility of treatment with intravenous...
journal_title:BMC pulmonary medicine
pub_type: 杂志文章,多中心研究
doi:10.1186/s12890-017-0474-7
更新日期:2017-12-02 00:00:00
abstract:BACKGROUND:Omega-3 fatty acids, including alpha-linolenic acid (ALA), eicosapentaenoic acid (EPA), docosahexaenoic acid (DHA) and derivatives, play a key role in the resolution of inflammation. Higher intake has been linked to decreased morbidity in several diseases, though effects on respiratory diseases like COPD are...
journal_title:BMC pulmonary medicine
pub_type: 杂志文章
doi:10.1186/s12890-019-0852-4
更新日期:2019-05-21 00:00:00
abstract:BACKGROUND:Hypoxemia is a major complication of COPD and is a strong predictor of mortality. We previously identified independent risk factors for the presence of resting hypoxemia in the COPDGene cohort. However, little is known about characteristics that predict onset of resting hypoxemia in patients who are normoxic...
journal_title:BMC pulmonary medicine
pub_type: 杂志文章,多中心研究
doi:10.1186/s12890-016-0331-0
更新日期:2016-12-01 00:00:00
abstract:BACKGROUND:Improvement in health-related quality of life (HRQL) has been suggested as an alternative treatment goal of non-tuberculous mycobacterial pulmonary disease (NTM-PD). This study was performed to elucidate the longitudinal changes in HRQL using St. George's Respiratory Questionnaire (SGRQ) among patients with ...
journal_title:BMC pulmonary medicine
pub_type: 杂志文章
doi:10.1186/s12890-020-1165-3
更新日期:2020-05-07 00:00:00
abstract:BACKGROUND:The dysfunction of airway epithelial barrier is closely related to the pathogenesis of asthma. Secreted Hsp90α participates in inflammation and Hsp90 inhibitor protects endothelial dysfunction. In the current study, we aimed to explore the role of secreted Hsp90α in asthmatic airway epithelial barrier functi...
journal_title:BMC pulmonary medicine
pub_type: 杂志文章
doi:10.1186/s12890-019-0938-z
更新日期:2019-11-20 00:00:00
abstract:BACKGROUND:During the past decades, numerous efforts have been made to decrease the death rate among lung cancer patients. Nonetheless, the improvement in long-term survival has been limited and lung cancer is still a devastating disease. DISCUSSION:With this article we would like to point out that survival of lung ca...
journal_title:BMC pulmonary medicine
pub_type: 杂志文章
doi:10.1186/1471-2466-12-77
更新日期:2012-12-13 00:00:00