Structured Abstract

Contents

• Preface
• Acknowledgments
• Technical Expert Panel
• Peer Reviewers
• Evidence Summary
  • Main Points
  • Background and Purpose
  • Methods
  • Results
  • Strengths and Limitations
  • Implications and Conclusions
  • References
• Introduction
  • Background
  • Scope of the Review
  • Purpose of the Review
• Methods
  • Review Approach
  • Study Selection
  • Data Extraction and Risk of Bias Assessment
  • Data Synthesis and Analysis
  • Grading the Strength of the Body of Evidence
• Results
  • Search Results
  • Key Question 1. What are the comparative benefits of nonpharmacological interventions (either alone or in combination) for improving breathlessness in patients with advanced cancer?
  • Respiratory Interventions
  • Behavioral/Psychoeducational Interventions
  • Activity/Rehabilitation Interventions
  • Integrative Medicine Interventions
  • Multicomponent Interventions
  • Combined Activity/Rehabilitation and Behavioral/Psychoeducational Interventions
  • Combined Activity/Rehabilitation, Behavioral/Psychoeducational, and Integrative Medicine
  • Behavioral, Psychoeducational, and Integrative Medicine
  • Key Question 2. What are the comparative benefits of pharmacological interventions (either alone or in combination) for improving breathlessness in patients with advanced cancer?
  • Key Question 3. What are the comparative benefits of nonpharmacological, pharmacological, and multimodal interventions for improving breathlessness in patients with advanced cancer?
  • Key Question 4. What are the harms of nonpharmacological and pharmacological interventions for improving breathlessness in patients with advanced cancer?
• Discussion
  • Findings in Relation to the Decisional Dilemma(s)
  • Strengths and Limitations
  • Applicability
  • Implications for Clinical Practice, Education, Research, or Health Policy
  • Conclusions
• References
• Abbreviations
• Appendixes
  • Appendix A. Methods
  • Appendix B. Excluded Studies
  • Appendix C. Results
  • Appendix D. Evidence Tables
  • Appendix E. PCORI Systematic Review Checklist

Suggested citation:

Dy SM, Gupta A, Waldfogel JM, Sharma R, Zhang A, Feliciano JL, Sedhom R, Day J, Gersten RA, Davidson PM, Bass EB. Interventions for Breathlessness in Patients With Advanced Cancer. Comparative Effectiveness Review No. 232. (Prepared by the Johns Hopkins University Evidence-based Practice Center under Contract No. 290-2015-00006-I for the Agency for Healthcare Research and Quality and the Patient-Centered Outcomes Research Institute.) AHRQ Publication No. 21-EHC024, PCORI Publication No. 2020-SR-01. Rockville, MD: Agency for Healthcare Research and Quality; November 2020. DOI: https://doi.org/10.23970/AHRQEPCCER232. Posted final reports are located on the Effective Health Care Program search page.

This report is based on research conducted by the Johns Hopkins University Evidence-based Practice Center (EPC) under contract to the Agency for Healthcare Research and Quality (AHRQ), Rockville, MD (Contract No. 290-2015-00006-I). The Patient-Centered Outcomes Research Institute (PCORI) funded the report (PCORI Publication No. 2020-SR-01). The findings and conclusions in this document are those of the authors, who are responsible for its contents; the findings and conclusions do not necessarily represent the views of AHRQ or PCORI. Therefore, no statement in this report should be construed as an official position of PCORI, AHRQ, or the U.S. Department of Health and Human Services.

None of the investigators have any affiliations or financial involvement that conflicts with the material presented in this report.

The information in this report is intended to help healthcare decision makers—patients and clinicians, health system leaders, and policymakers, among others—make well-informed decisions and thereby improve the quality of healthcare services. This report is not intended to be a substitute for the application of clinical judgment. Anyone who makes decisions concerning the provision of clinical care should consider this report in the same way as any medical reference and in conjunction with all other pertinent information, i.e., in the context of available resources and circumstances presented by individual patients.

This report is made available to the public under the terms of a licensing agreement between the author and the Agency for Healthcare Research and Quality. This report may be used and reprinted without permission except those copyrighted materials that are clearly noted in the report. Further reproduction of those copyrighted materials is prohibited without the express permission of copyright holders.

PCORI, AHRQ, or U.S. Department of Health and Human Services endorsement of any derivative products that may be developed from this report, such as clinical practice guidelines, other quality enhancement tools, or reimbursement or coverage policies, may not be stated or implied.

AHRQ appreciates appropriate acknowledgment and citation of its work. Suggested language for acknowledgment: This work was based on an evidence report, Interventions for Breathlessness in Patients With Advanced Cancer, by the Evidence-based Practice Center Program at the Agency for Healthcare Research and Quality (AHRQ).