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Holland AE, Spathis A, Marsaa K, Bausewein C, Ahmadi Z, Burge AT, Pascoe A, Gadowski AM, Collis P, Jelen T, Reilly CC, Reinke LF, Romero L, Russell AM, Saggu R, Solheim J, Vagheggini G, Vandendungen C, Wijsenbeek M, Tonia T, Smallwood N, Ekström M. European Respiratory Society clinical practice guideline on symptom management for adults with serious respiratory illness. Eur Respir J 2024; 63:2400335. [PMID: 38719772 DOI: 10.1183/13993003.00335-2024] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/15/2024] [Accepted: 03/19/2024] [Indexed: 06/30/2024]
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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Affiliation(s)
- Anne E Holland
- Departments of Physiotherapy and Respiratory Medicine, Alfred Health, Melbourne, Australia
- School of Translational Medicine, Monash University, Melbourne, Australia
- Institute for Breathing and Sleep, Melbourne, Australia
| | - Anna Spathis
- Department of Public Health and Primary Care, University of Cambridge, Cambridge, UK
| | - Kristoffer Marsaa
- Department of Multidisease, North Zealand Hospital, Copenhagen University, Hilleroed, Denmark
| | - Claudia Bausewein
- Department of Palliative Medicine, LMU University Hospital, LMU Munich, Munich, Germany
| | - Zainab Ahmadi
- Respiratory Medicine, Allergology and Palliative Medicine, Department of Clinical Sciences Lund, Lund University, Lund, Sweden
| | - Angela T Burge
- School of Translational Medicine, Monash University, Melbourne, Australia
- Department of Physiotherapy, Alfred Health, Melbourne, Australia
| | - Amy Pascoe
- School of Translational Medicine, Monash University, Melbourne, Australia
| | - Adelle M Gadowski
- School of Translational Medicine, Monash University, Melbourne, Australia
| | - Phil Collis
- CPROR Birmingham University, Birmingham, UK
- Patient Advisory Group, European Lung Foundation, Sheffield, UK
| | - Tessa Jelen
- Patient Advisory Group, European Lung Foundation, Sheffield, UK
| | - Charles C Reilly
- Department of Physiotherapy, King's College Hospital, London, UK
- Cicely Saunders Institute of Palliative Care, Policy and Rehabilitation, King's College London, London, UK
| | - Lynn F Reinke
- College of Nursing, University of Utah, Salt Lake City, UT, USA
| | - Lorena Romero
- The Ian Potter Library, Alfred Health, Melbourne, Australia
| | - Anne-Marie Russell
- Institute of Clinical Sciences, University of Birmingham, Birmingham, UK
- Birmingham Regional NHS Interstitial Lung Disease and Occupational Lung Disease Service, University Hospitals Birmingham NHS Foundation Trust, Birmingham, UK
| | - Ravijyot Saggu
- Pharmacy Medicines Management Team, Central London Community Healthcare Trust, London, UK
| | - John Solheim
- EU-PFF - European Pulmonary Fibrosis Federation, Overijse, Belgium
- LHL-IPF, Jessheim, Norway
| | - Guido Vagheggini
- Department of Internal Medicine and Medical Specialties, Respiratory Failure Pathway, Azienda USL Toscana Nordovest, Pisa, Italy
- Fondazione Volterra Ricerche ONLUS, Volterra, Italy
| | - Chantal Vandendungen
- EU-PFF - European Pulmonary Fibrosis Federation, Overijse, Belgium
- ABFFP - Association Belge Francophone Contre la Fibrose Pulmonaire, Rebecq, Belgium
| | - Marlies Wijsenbeek
- Department of Respiratory Medicine, Erasmus University Medical Center, Center of Excellence for Interstitial Lung Disease, Rotterdam, The Netherlands
| | - Thomy Tonia
- Institute of Social and Preventive Medicine, University of Bern, Bern, Switzerland
| | - Natasha Smallwood
- School of Translational Medicine, Monash University, Melbourne, Australia
- Department of Respiratory Medicine, Alfred Health, Melbourne, Australia
- Joint last authors
| | - Magnus Ekström
- Respiratory Medicine, Allergology and Palliative Medicine, Department of Clinical Sciences Lund, Lund University, Lund, Sweden
- Joint last authors
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Kirk S, Pryjmachuk S. 'People don't realise how much their past experiences affect them in adulthood': A qualitative study of adult siblings' experiences of growing-up with a sister/brother with a childhood life-limiting condition and their perceived support needs. Palliat Med 2024; 38:352-363. [PMID: 38342911 PMCID: PMC10955783 DOI: 10.1177/02692163231225100] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/13/2024]
Abstract
BACKGROUND There is a lack of research about the experiences and impact of having a sibling with a life-limiting condition. Studies focus on the sibling experience during childhood but the experience and impact during adulthood is unknown despite the increased life-expectancy of children with life-limiting conditions. AIM To explore adult siblings' perspectives on the experience of having a sister/brother with a childhood life-limiting condition and to identify their perceived needs and preferences for support. DESIGN A qualitative exploratory study design with data generated by semi-structured interviews and analysed using reflexive thematic analysis, underpinned by interpretivism. SETTING/PARTICIPANTS Twenty-two siblings (17-42 years old) were recruited via a children's hospice in England. RESULTS The experience of having a sibling with a life-limiting condition changes over time in response to how understandings of the meaning of a life-limiting condition develop and changing roles/relationships with parents and siblings. These experiences have an enduring impact on adult sibling's mental health which is compounded by their unmet (and sometimes unrecognised) support needs in adolescence and adulthood. Siblings described the importance of support continuing into adulthood with a focus on the provision of psychotherapy and peer support. CONCLUSIONS Having a sister/brother with a childhood life-limiting condition appeared to have a significant and ongoing impact on adult siblings but their support needs, particularly for psychotherapy and peer support, are overlooked. The findings highlight the importance of ensuring siblings are included in family assessments and that family-based interventions are developed to promote sibling-parent relationships.
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Affiliation(s)
- Susan Kirk
- School of Health Sciences, University of Manchester, Manchester, UK
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Jha A, Ward T, Walker S, Goodwin AT, Chalmers JD. Review of the British Thoracic Society Winter Meeting 2021, 24-26 November 2021. Thorax 2022; 77:1030-1035. [PMID: 35907640 DOI: 10.1136/thorax-2022-219150] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/29/2022] [Accepted: 07/13/2022] [Indexed: 11/04/2022]
Abstract
The Winter Meeting of the British Thoracic Society (BTS) is a platform for the latest clinical and scientific research in respiratory medicine. This review summarises the key symposia and presentations from the BTS Winter Meeting 2021 held online due to the COVID-19 pandemic.
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Affiliation(s)
- Akhilesh Jha
- Department of Medicine, University of Cambridge, Cambridge, UK
| | - Tom Ward
- Department of Respiratory Sciences, University of Leicester, Leicester, UK
| | - Steven Walker
- School of Clinical Sciences, University of Bristol Academic Respiratory Unit, Westbury on Trym, UK
| | - Amanda T Goodwin
- Nottingham NIHR Respiratory Biomedical Research Centre, University of Nottingham, Nottingham, UK
| | - James D Chalmers
- Division of Molecular and Clinical Medicine, Ninewells Hospital and Medical School, University of Dundee, Dundee, UK
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