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Perspectives on palliative oxygen for breathlessness: Systematic review and meta-synthesis

Slavica Kochovska, Diana H. Ferreira, Maja V. Garcia, Jane L. Phillips, David C. Currow
European Respiratory Journal 2021; DOI: 10.1183/13993003.04613-2020
Slavica Kochovska
1IMPACCT, Faculty of Health, University of Technology Sydney, Sydney, New South Wales, Australia
4S.K. and D.F. are joint first authors
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Diana H. Ferreira
2Discipline Palliative and Supportive Services, Flinders University, Adelaide, South Australia, Australia
4S.K. and D.F. are joint first authors
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Maja V. Garcia
1IMPACCT, Faculty of Health, University of Technology Sydney, Sydney, New South Wales, Australia
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Jane L. Phillips
1IMPACCT, Faculty of Health, University of Technology Sydney, Sydney, New South Wales, Australia
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David C. Currow
1IMPACCT, Faculty of Health, University of Technology Sydney, Sydney, New South Wales, Australia
3Wolfson Palliative Care Research Centre, University of Hull, Hull, UK
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Abstract

Oxygen therapy is frequently prescribed for the palliation of breathlessness, despite lack of evidence for its effectiveness in people who are not hypoxaemic. This study aimed to compare and contrast patients’, caregivers’ and clinicians’ experiences of palliative oxygen use for the relief of chronic breathlessness in people with advanced life-limiting illnesses, and how this shapes prescribing.

A systematic review and meta-synthesis of qualitative data was conducted. MEDLINE, CINAHL and PsycINFO were searched for peer-reviewed studies in English (2000-present) reporting perspectives on palliative oxygen use for reducing breathlessness in people with advanced illnesses in any healthcare setting. After data extraction, thematic synthesis used line-by-line coding of raw data (quotes) to generate descriptive and analytical themes.

Of 457 articles identified, 22 met the inclusion criteria by reporting perspectives of patients (n=337), caregivers (n=91) or clinicians (n=616). Themes common to these perspectives were: 1) benefits and burdens of palliative oxygen use; 2) knowledge and perceptions of palliative oxygen use beyond the guidelines; and 3) longitudinal trajectories of palliative oxygen use.

There are differing perceptions regarding the benefits and burdens of using palliative oxygen. Clinicians should be aware that oxygen use may generate differing goals of therapy for patients and caregivers. These perceptions should be taken into consideration when prescribing oxygen for the symptomatic relief of chronic breathlessness in patients who do not quality for long term oxygen therapy.

Footnotes

This manuscript has recently been accepted for publication in the European Respiratory Journal. It is published here in its accepted form prior to copyediting and typesetting by our production team. After these production processes are complete and the authors have approved the resulting proofs, the article will move to the latest issue of the ERJ online. Please open or download the PDF to view this article.

Conflict of interest: Dr. Lindner has nothing to disclose.

Conflict of interest: Dr. Kochovska has nothing to disclose.

Conflict of interest: Dr. Ferreira has nothing to disclose.

Conflict of interest: Ms. Garcia has nothing to disclose.

Conflict of interest: Dr. Phillips has nothing to disclose.

Conflict of interest: Dr. Currow reports he is an unpaid advisory board member for Helsinn Pharmaceuticals. He is a paid consultant and receives payment for intellectual property with Mayne Pharma and is a consultant with Specialised Therapeutics Australia Pty. Ltd.

  • Received September 24, 2020.
  • Accepted February 15, 2021.
  • Copyright ©The authors 2021. For reproduction rights and permissions contact permissions{at}ersnet.org
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Perspectives on palliative oxygen for breathlessness: Systematic review and meta-synthesis
Slavica Kochovska, Diana H. Ferreira, Maja V. Garcia, Jane L. Phillips, David C. Currow
European Respiratory Journal Jan 2021, 2004613; DOI: 10.1183/13993003.04613-2020

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Perspectives on palliative oxygen for breathlessness: Systematic review and meta-synthesis
Slavica Kochovska, Diana H. Ferreira, Maja V. Garcia, Jane L. Phillips, David C. Currow
European Respiratory Journal Jan 2021, 2004613; DOI: 10.1183/13993003.04613-2020
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