Project Summary
The Patient-Centered Outcomes Research Institute (PCORI) commissioned, via the Agency for Healthcare Research and Quality (AHRQ), a systematic evidence review of pharmacological and nonpharmacological interventions for the management of dyspnea, or breathlessness, in patients with advanced cancer. The purpose of this update is to fulfill a requirement of PCORI’s authorizing mandate, which is “to engage in evidence synthesis, in order to make information from comparative clinical effectiveness research available to patients and providers so that they can make better-informed health care decisions.” The focus of this systematic review is to evaluate evidence regarding: (1) pharmacological interventions (including opioid and other pharmacological interventions), and (2) nonpharmacological interventions (such as oxygen therapy, respiratory training, and behavioral therapy), utilized to alleviate dyspnea, or breathlessness, in patients with advanced cancer.
Dyspnea refers to difficulty breathing, or shortness of breath, and is a common symptom in patients with advanced cancer. While dyspnea can be profoundly distressing for patients and their caregivers, it is also challenging for clinicians to manage symptoms of dyspnea. The American Society for Clinical Oncology’s Supportive Care Guideline Advisory Group has identified dyspnea in patients with advanced cancer as an important topic for a new guideline. Therefore, the objective of this systematic review is to identify and synthesize evidence necessary to support a comprehensive and clinically targeted clinical practice guideline.
With input from clinical experts and stakeholders, the following Key Questions have been determined:
Key Questions
- What are the comparative benefits of nonpharmacological interventions (either alone or in combination) for improving breathlessness in patients with advanced cancer?
- What are the comparative benefits of pharmacological interventions (either alone or in combination) for improving breathlessness in patients with advanced cancer?
- What are the comparative benefits of nonpharmacological, pharmacological, and multimodal interventions for improving breathlessness in patients with advanced cancer?
- What are the harms of nonpharmacological and pharmacological interventions for improving breathlessness in patients with advanced cancer?
- Evidence Summary
- Final Protocol for This Review
- Stakeholder Webinar
- AHRQ Project Page
- Management of Dyspnea in Advanced Cancer: ASCO Guideline*
- View Systematic Review Report (Published November 2020)
*These guidelines were developed by an external organization or a third party and PCORI is not responsible for any content contained therein. In addition, PCORI does not fund and is not involved in the creation of clinical practice guidelines.