Chest
Consensus StatementAmerican College of Chest Physicians Consensus Statement on the Management of Dyspnea in Patients With Advanced Lung or Heart Disease
Section snippets
Executive Summary
This consensus statement was initiated based on the understanding that patients with advanced lung or heart disease are not currently being treated consistently and effectively for relief of dyspnea. The purpose is to summarize available evidence in order to improve the care and treatment of dyspnea in this population. An expert panel of specialists in pulmonary medicine, cardiology, nursing, and palliative care developed our findings. Selection of the expert panel and the development of the
Literature Search
The ACCP research methodologist performed a MEDLINE literature search of English language articles on human subjects for the period of 1966 to 2008. The purpose of the literature search was to evaluate published studies on this topic condition and to identify topic domains that would form the basis of the consensus survey. The following search strategy and key terms were used to capture studies relevant to the topic:
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Patient population: advanced, severe, end-stage, end-of-life lung or
Results
The results of the literature review are presented in tables located in the Appendices. The results of the Delphi survey are presented in Table 2, Table 3, Table 4, Table 5, Table 6, Table 7.
Discussion
Despite the high prevalence of dyspnea in patients with advanced lung or heart disease, the current literature review and previous reviews demonstrate the paucity of scientific data on the management of this symptom.1, 27, 76, 99, 100 The majority of RCTs on this topic have focused on patients with advanced COPD, whereas information addressing dyspnea management in patients with advanced heart disease is quite limited.
With the Delphi method, consensus was achieved on 20 of 23 statements.
Summary
This consensus statement was initiated based on the understanding that patients with advanced lung or heart disease are not currently being treated consistently and effectively for relief of dyspnea. The purpose was to provide suggestions to improve the treatment of dyspnea in this patient population. The results of the literature review demonstrated a paucity of scientific information on this topic. Using the Delphi method to develop consensus, acceptable agreement was achieved for 20 of 23
Acknowledgments
Financial/nonfinancial disclosures: The authors have reported to CHEST the following conflicts of interest: Dr Carrieri-Kohlman has received grant money covering a small portion of her salary from an NIH RO1 grant entitled “Dsypnea Self-Management: Internet or Face-to-Face.” The overall aim of this proposal is to compare the impact of a new Internet-based dyspnea self-management program (I-DSMP) with a face-to-face program (f-DSMP) and an Attention Control (AC) that has been shown to be
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Funding/Support: This project was commissioned by the American College of Chest Physicians (ACCP) and is considered an official project of this organization.
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