AUTHOR=Yates Patsy , Hardy Janet , Clavarino Alexandra , Fong Kwun M. , Mitchell Geoffrey , Skerman Helen , Brunelli Vanessa , Zhao Isabella 

TITLE=A Randomized Controlled Trial of a Non-pharmacological Intervention for Cancer-Related Dyspnea

JOURNAL=Frontiers in Oncology

VOLUME=10

YEAR=2020

URL=https://www.frontiersin.org/journals/oncology/articles/10.3389/fonc.2020.591610

DOI=10.3389/fonc.2020.591610

ISSN=2234-943X

ABSTRACT=<p><bold>Objectives:</bold> To evaluate the efficacy of a brief tailored non-pharmacological intervention comprising breathing retraining and psychosocial support for managing dyspnea in cancer patients.</p><p><bold>Design:</bold> Multicenter, single blinded, parallel group, randomized controlled trial.</p><p><bold>Setting:</bold> Four major public hospitals, Brisbane, Australia.</p><p><bold>Participants:</bold> One hundred and forty four cancer patients, including 81 who received an 8-week tailored intervention and 63 who received standard care.</p><p><bold>Inclusion Criteria:</bold> Diagnosis of small or non-small cell lung cancer, mesothelioma or lung metastases; completed first line therapy for the disease; average dyspnea rating &gt;2 on (0–10) rating scale in past week; anticipated life expectancy ≥3 months.</p><p><bold>Outcomes:</bold> The primary outcome measure was change in “worst” dyspnea at 8 weeks compared to baseline. Secondary outcomes were change in: dyspnea “at best” and “on average”; distress; perceived control over dyspnea; functional status, psychological distress; and use of non-pharmacological interventions to manage dyspnea at 8 weeks relative to baseline.</p><p><bold>Results:</bold> The mean age of participants was 67.9 (SD = 9.6) years. Compared to the control group, the intervention group demonstrated a statistically significant: (i) improvement in average dyspnea from T1(<italic>M</italic> = 4.5, SE = 0.22) to T3 (<italic>M</italic> = 3.6, SE = 0.24) vs. (<italic>M</italic> = 3.8, SE = 0.24) to (<italic>M</italic> = 4.1, SE = 0.26); (ii) greater control over dyspnea from T1 (<italic>M</italic> = 5.7, SE = 0.28) to T3 (<italic>M</italic> = 7.5, SE = 0.31) vs. (<italic>M</italic> = 6.8, SE = 0.32) to (<italic>M</italic> = 6.6, SE = 0.33); and (iii) greater reduction in anxiety from T1 (<italic>M</italic> = 5.4, SE = 0.43) to T3 (<italic>M</italic> = 4.5, SE = 0.45) vs. (<italic>M</italic> = 4.2, SE = 0.49) to (<italic>M</italic> = 4.6, SE = 0.50). This study found no intervention effect for best and worst dyspnea, distress from breathlessness, functional status, and depression over time.</p><p><bold>Conclusions:</bold> This study demonstrates efficacy of tailored non-pharmacological interventions in improving dyspnea on average, control over dyspnea, and anxiety for cancer patients.</p><p><bold>Clinical Trial Registration:</bold> The trial is registered at the Australian New Zealand Clinical Trials Registry (<ext-link ext-link-type="uri" xlink:href="http://www.anzctr.org.au" xmlns:xlink="http://www.w3.org/1999/xlink">http://www.anzctr.org.au</ext-link>). The registration number is ACTRN12607000087459.</p>