RT Journal Article
SR Electronic
T1 Effectiveness of a specialised breathlessness service for patients with advanced disease in Germany: a pragmatic fast-track randomised controlled trial (BreathEase)
JF European Respiratory Journal
JO Eur Respir J
FD European Respiratory Society
SP 2002139
DO 10.1183/13993003.02139-2020
VO 58
IS 2
A1 Michaela Schunk
A1 Lien Le
A1 Zulfiya Syunyaeva
A1 Birgit Haberland
A1 Susanne Tänzler
A1 Ulrich Mansmann
A1 Larissa Schwarzkopf
A1 Hildegard Seidl
A1 Sabine Streitwieser
A1 Miriam Hofmann
A1 Thomas Müller
A1 Tobias Weiß
A1 Philipp Morawietz
A1 Eva Annette Rehfuess
A1 Rudolf Maria Huber
A1 Ursula Berger
A1 Claudia Bausewein
YR 2021
UL http://erj.ersjournals.com/content/58/2/2002139.abstract
AB Background The effectiveness of the Munich Breathlessness Service (MBS), integrating palliative care, respiratory medicine and physiotherapy, was tested in the BreathEase trial in patients with chronic breathlessness in advanced disease and their carers.Methods BreathEase was a single-blinded randomised controlled fast-track trial. The MBS was attended for 5–6 weeks; the control group started the MBS after 8 weeks of standard care. Randomisation was stratified by cancer and the presence of a carer. Primary outcomes were patients’ mastery of breathlessness (Chronic Respiratory Disease Questionnaire (CRQ) Mastery), quality of life (CRQ QoL), symptom burden (Integrated Palliative care Outcome Scale (IPOS)) and carer burden (Zarit Burden Interview (ZBI)). Intention-to-treat (ITT) analyses were conducted with hierarchical testing. Effectiveness was investigated by linear regression on change scores, adjusting for baseline scores and stratification variables. Missing values were handled with multiple imputation.Results 92 patients were randomised to the intervention group and 91 patients were randomised to the control group. Before the follow-up assessment after 8 weeks (T1), 17 and five patients dropped out from the intervention and control groups, respectively. Significant improvements in CRQ Mastery of 0.367 (95% CI 0.065–0.669) and CRQ QoL of 0.226 (95% CI 0.012–0.440) score units at T1 in favour of the intervention group were seen in the ITT analyses (n=183), but not in IPOS. Exploratory testing showed nonsignificant improvements in ZBI.Conclusions These findings demonstrate positive effects of the MBS in reducing burden caused by chronic breathlessness in advanced illness across a wide range of patients. Further evaluation in subgroups of patients and with a longitudinal perspective is needed.The effectiveness of the Munich Breathlessness Service (MBS) was tested in a single-blinded randomised controlled fast-track trial. Significant improvements were shown in mastery of breathlessness and quality of life in patients with advanced illness. https://bit.ly/3nT8jfT