Low-intensity educational interventions supporting self-management to improve outcomes related to chronic breathlessness: a systematic review.
Bronwyn Raymond, Tim Luckett, Miriam Johnson, Ann Hutchinson, Melanie Lovell, Jane Phillips
Author Information
Bronwyn Raymond: IMPACCT - Improving Palliative, Aged and Chronic Care through Clinical Research and Translation, Faculty of Health, University of Technology Sydney, 235-253 Jones Street, Ultimo, NSW, 2007, Australia. ORCID
Tim Luckett: IMPACCT - Improving Palliative, Aged and Chronic Care through Clinical Research and Translation, Faculty of Health, University of Technology Sydney, 235-253 Jones Street, Ultimo, NSW, 2007, Australia. Tim.Luckett@uts.edu.au.
Miriam Johnson: Hull York Medical School, University of York, John Hughlings Jackson Building, Heslington, York, Y010 5DD, UK.
Ann Hutchinson: Hull York Medical School, University of York, John Hughlings Jackson Building, Heslington, York, Y010 5DD, UK.
Melanie Lovell: HammondCare, 95-115 River Road, Greenwich, NSW, 2065, Australia.
Jane Phillips: IMPACCT - Improving Palliative, Aged and Chronic Care through Clinical Research and Translation, Faculty of Health, University of Technology Sydney, 235-253 Jones Street, Ultimo, NSW, 2007, Australia. ORCID
Chronic breathlessness is debilitating and frightening, often resulting in emergency department presentations with acute-on-chronic breathlessness. Self-management is complex, involving 14 components as identified by the Practical Systematic Review in Self-Management Support (PRISMS). Low-intensity educational interventions that support breathlessness self-management through written/visual educational materials, alongside limited health professional support, are available. Our aim was to describe components of low-intensity educational interventions that support and improve self-management for adults with chronic breathlessness and evaluate their efficacy for improving breathlessness-related outcomes. A systematic review was conducted, including RCTs that compared these interventions with usual care in adults with chronic disease. Synthesis took a narrative approach utilizing the PRISMS taxonomy and Template for Intervention Description and Replication (TIDieR) checklist. Of the 1948 articles identified, 7 met criteria reporting 7 RCTs using 6 interventions. Studies utilized 12 out of 14 PRISMS components, the most frequent being training/rehearsal for psychological strategies. Evidence for effectiveness was inconsistent and attempts to identify beneficial components were confounded by intervention complexity and heterogeneity. The optimal content and delivery of low-intensity educational interventions that support self-management to improve chronic breathlessness-related outcomes in adults cannot be defined from current published literature. Future research should incorporate more detailed, standardized reporting to enable comparison and meta-analysis.
References
Ann Am Thorac Soc. 2013 Oct;10(5):S98-106
[PMID: 24161068]
