European Respiratory Society clinical practice guideline on symptom management for adults with serious respiratory illness
Respiratory symptoms are ubiquitous and impair health-related quality of life in people with respiratory disease. This European Respiratory Society (ERS) task force aimed to provide recommendations for symptomatic treatment in people with serious respiratory illness. The ERS task force comprised 16...
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| Vydáno v: | The European respiratory journal Ročník 63; číslo 6 |
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| Hlavní autoři: | , , , , , , , , , , , , , , , , , , , , , |
| Médium: | Journal Article |
| Jazyk: | angličtina |
| Vydáno: |
England
01.06.2024
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| ISSN: | 1399-3003, 1399-3003 |
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| Abstract | Respiratory symptoms are ubiquitous and impair health-related quality of life in people with respiratory disease. This European Respiratory Society (ERS) task force aimed to provide recommendations for symptomatic treatment in people with serious respiratory illness. The ERS task force comprised 16 members, including representatives of people with serious respiratory illness and informal caregivers. Seven questions were formulated, six in the PICO (Population, Intervention, Comparison, Outcome) format, which were addressed with full systematic reviews and evidence assessed using GRADE (Grading of Recommendations Assessment, Development and Evaluation). One question was addressed narratively. An "evidence-to-decision" framework was used to formulate recommendations. To treat symptoms in people with serious respiratory illness, the task force suggests the use of graded exercise therapy (conditional recommendation, low certainty of evidence); and suggests the use of a multicomponent services, handheld fan and breathing techniques (conditional recommendations, very low certainty of evidence). The task force suggests not to use opioids (conditional recommendation, very low certainty of evidence); and suggests either administering or not administering supplemental oxygen therapy (conditional recommendation, low certainty of evidence). The task force suggests that needs assessment tools may be used as part of a comprehensive needs assessment, but do not replace patient-centred care and shared decision making (conditional recommendation, low certainty of evidence). The low certainty of evidence, modest impact of interventions on patient-centred outcomes, and absence of effective strategies to ameliorate cough highlight the need for new approaches to reduce symptoms and enhance wellbeing for individuals who live with serious respiratory illness. |
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| AbstractList | Respiratory symptoms are ubiquitous and impair health-related quality of life in people with respiratory disease. This European Respiratory Society (ERS) task force aimed to provide recommendations for symptomatic treatment in people with serious respiratory illness. The ERS task force comprised 16 members, including representatives of people with serious respiratory illness and informal caregivers. Seven questions were formulated, six in the PICO (Population, Intervention, Comparison, Outcome) format, which were addressed with full systematic reviews and evidence assessed using GRADE (Grading of Recommendations Assessment, Development and Evaluation). One question was addressed narratively. An "evidence-to-decision" framework was used to formulate recommendations. To treat symptoms in people with serious respiratory illness, the task force suggests the use of graded exercise therapy (conditional recommendation, low certainty of evidence); and suggests the use of a multicomponent services, handheld fan and breathing techniques (conditional recommendations, very low certainty of evidence). The task force suggests not to use opioids (conditional recommendation, very low certainty of evidence); and suggests either administering or not administering supplemental oxygen therapy (conditional recommendation, low certainty of evidence). The task force suggests that needs assessment tools may be used as part of a comprehensive needs assessment, but do not replace patient-centred care and shared decision making (conditional recommendation, low certainty of evidence). The low certainty of evidence, modest impact of interventions on patient-centred outcomes, and absence of effective strategies to ameliorate cough highlight the need for new approaches to reduce symptoms and enhance wellbeing for individuals who live with serious respiratory illness.Respiratory symptoms are ubiquitous and impair health-related quality of life in people with respiratory disease. This European Respiratory Society (ERS) task force aimed to provide recommendations for symptomatic treatment in people with serious respiratory illness. The ERS task force comprised 16 members, including representatives of people with serious respiratory illness and informal caregivers. Seven questions were formulated, six in the PICO (Population, Intervention, Comparison, Outcome) format, which were addressed with full systematic reviews and evidence assessed using GRADE (Grading of Recommendations Assessment, Development and Evaluation). One question was addressed narratively. An "evidence-to-decision" framework was used to formulate recommendations. To treat symptoms in people with serious respiratory illness, the task force suggests the use of graded exercise therapy (conditional recommendation, low certainty of evidence); and suggests the use of a multicomponent services, handheld fan and breathing techniques (conditional recommendations, very low certainty of evidence). The task force suggests not to use opioids (conditional recommendation, very low certainty of evidence); and suggests either administering or not administering supplemental oxygen therapy (conditional recommendation, low certainty of evidence). The task force suggests that needs assessment tools may be used as part of a comprehensive needs assessment, but do not replace patient-centred care and shared decision making (conditional recommendation, low certainty of evidence). The low certainty of evidence, modest impact of interventions on patient-centred outcomes, and absence of effective strategies to ameliorate cough highlight the need for new approaches to reduce symptoms and enhance wellbeing for individuals who live with serious respiratory illness. Respiratory symptoms are ubiquitous and impair health-related quality of life in people with respiratory disease. This European Respiratory Society (ERS) task force aimed to provide recommendations for symptomatic treatment in people with serious respiratory illness. The ERS task force comprised 16 members, including representatives of people with serious respiratory illness and informal caregivers. Seven questions were formulated, six in the PICO (Population, Intervention, Comparison, Outcome) format, which were addressed with full systematic reviews and evidence assessed using GRADE (Grading of Recommendations Assessment, Development and Evaluation). One question was addressed narratively. An "evidence-to-decision" framework was used to formulate recommendations. To treat symptoms in people with serious respiratory illness, the task force suggests the use of graded exercise therapy (conditional recommendation, low certainty of evidence); and suggests the use of a multicomponent services, handheld fan and breathing techniques (conditional recommendations, very low certainty of evidence). The task force suggests not to use opioids (conditional recommendation, very low certainty of evidence); and suggests either administering or not administering supplemental oxygen therapy (conditional recommendation, low certainty of evidence). The task force suggests that needs assessment tools may be used as part of a comprehensive needs assessment, but do not replace patient-centred care and shared decision making (conditional recommendation, low certainty of evidence). The low certainty of evidence, modest impact of interventions on patient-centred outcomes, and absence of effective strategies to ameliorate cough highlight the need for new approaches to reduce symptoms and enhance wellbeing for individuals who live with serious respiratory illness. |
| Author | Reinke, Lynn F Solheim, John Bausewein, Claudia Burge, Angela T Wijsenbeek, Marlies Pascoe, Amy Ekström, Magnus Tonia, Thomy Collis, Phil Ahmadi, Zainab Jelen, Tessa Smallwood, Natasha Russell, Anne-Marie Saggu, Ravijyot Vagheggini, Guido Marsaa, Kristoffer Spathis, Anna Reilly, Charles C Gadowski, Adelle M Romero, Lorena Vandendungen, Chantal Holland, Anne E |
| Author_xml | – sequence: 1 givenname: Anne E orcidid: 0000-0003-2061-845X surname: Holland fullname: Holland, Anne E email: a.holland@alfred.org.au organization: Institute for Breathing and Sleep, Melbourne, Australia – sequence: 2 givenname: Anna surname: Spathis fullname: Spathis, Anna organization: Department of Public Health and Primary Care, University of Cambridge, Cambridge, UK – sequence: 3 givenname: Kristoffer surname: Marsaa fullname: Marsaa, Kristoffer organization: Department of Multidisease, North Zealand Hospital, Copenhagen University, Hilleroed, Denmark – sequence: 4 givenname: Claudia orcidid: 0000-0002-0958-3041 surname: Bausewein fullname: Bausewein, Claudia organization: Department of Palliative Medicine, LMU University Hospital, LMU Munich, Munich, Germany – sequence: 5 givenname: Zainab surname: Ahmadi fullname: Ahmadi, Zainab organization: Respiratory Medicine, Allergology and Palliative Medicine, Department of Clinical Sciences Lund, Lund University, Lund, Sweden – sequence: 6 givenname: Angela T surname: Burge fullname: Burge, Angela T organization: Department of Physiotherapy, Alfred Health, Melbourne, Australia – sequence: 7 givenname: Amy orcidid: 0000-0002-3555-6856 surname: Pascoe fullname: Pascoe, Amy organization: School of Translational Medicine, Monash University, Melbourne, Australia – sequence: 8 givenname: Adelle M surname: Gadowski fullname: Gadowski, Adelle M organization: School of Translational Medicine, Monash University, Melbourne, Australia – sequence: 9 givenname: Phil surname: Collis fullname: Collis, Phil organization: Patient Advisory Group, European Lung Foundation, Sheffield, UK – sequence: 10 givenname: Tessa surname: Jelen fullname: Jelen, Tessa organization: Patient Advisory Group, European Lung Foundation, Sheffield, UK – sequence: 11 givenname: Charles C orcidid: 0000-0003-2520-2859 surname: Reilly fullname: Reilly, Charles C organization: Cicely Saunders Institute of Palliative Care, Policy and Rehabilitation, King's College London, London, UK – sequence: 12 givenname: Lynn F surname: Reinke fullname: Reinke, Lynn F organization: College of Nursing, University of Utah, Salt Lake City, UT, USA – sequence: 13 givenname: Lorena surname: Romero fullname: Romero, Lorena organization: The Ian Potter Library, Alfred Health, Melbourne, Australia – sequence: 14 givenname: Anne-Marie orcidid: 0000-0002-0468-3537 surname: Russell fullname: Russell, Anne-Marie organization: Birmingham Regional NHS Interstitial Lung Disease and Occupational Lung Disease Service, University Hospitals Birmingham NHS Foundation Trust, Birmingham, UK – sequence: 15 givenname: Ravijyot surname: Saggu fullname: Saggu, Ravijyot organization: Pharmacy Medicines Management Team, Central London Community Healthcare Trust, London, UK – sequence: 16 givenname: John surname: Solheim fullname: Solheim, John organization: LHL-IPF, Jessheim, Norway – sequence: 17 givenname: Guido orcidid: 0000-0001-6733-2809 surname: Vagheggini fullname: Vagheggini, Guido organization: Fondazione Volterra Ricerche ONLUS, Volterra, Italy – sequence: 18 givenname: Chantal surname: Vandendungen fullname: Vandendungen, Chantal organization: ABFFP - Association Belge Francophone Contre la Fibrose Pulmonaire, Rebecq, Belgium – sequence: 19 givenname: Marlies surname: Wijsenbeek fullname: Wijsenbeek, Marlies organization: Department of Respiratory Medicine, Erasmus University Medical Center, Center of Excellence for Interstitial Lung Disease, Rotterdam, The Netherlands – sequence: 20 givenname: Thomy surname: Tonia fullname: Tonia, Thomy organization: Institute of Social and Preventive Medicine, University of Bern, Bern, Switzerland – sequence: 21 givenname: Natasha surname: Smallwood fullname: Smallwood, Natasha organization: Joint last authors – sequence: 22 givenname: Magnus surname: Ekström fullname: Ekström, Magnus organization: Joint last authors |
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| Title | European Respiratory Society clinical practice guideline on symptom management for adults with serious respiratory illness |
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