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PapersMulticentre randomised controlled trial of nursing intervention for breathlessness in patients with lung cancer

BMJ 1999; 318 doi: (Published 03 April 1999) Cite this as: BMJ 1999;318:901


    • Accepted 15 December 1998

    Multicentre randomised controlled trial of nursing intervention for breathlessness in patients with lung cancer

    1. Mary Bredin, Macmillan research practitionera,
    2. Jessica Corner, professor of cancer nursing (jessica{at},
    3. Meinir Krishnasamy, Macmillan research coordinatora,
    4. Hilary Plant, research practitionerb,
    5. Chris Bailey, research practitionerb,
    6. Roger A'Hern, statistician.c
    1. aCentre for Cancer and Palliative Care Studies, Macmillan Practice Development Unit, Institute of Cancer Research, Royal Marsden NHS Trust, London SW3 6JJ
    2. bCentre for Cancer and Palliative Care Studies, Institute of Cancer Research
    3. cDepartment of Computing and Information, Royal Marsden NHS Trust
    1. Correspondence to: Jessica Corner


      Objective:To evaluate the effectiveness of nursing intervention for breathlessness in patients with lung cancer.

      Design: Patients diagnosed with lung cancer participated in a multicentre randomised controlled trial where they either attended a nursing clinic offering intervention for their breathlessness or received best supportive care. The intervention consisted of a range of strategies combining breathing control, activity pacing, relaxation techniques, and psychosocial support. Best supportive care involved receiving standard management and treatment available for breathlessness, and breathing assessments. Participants completed a range of self assessment questionnaires at baseline, 4 weeks, and 8 weeks.

      Setting: Nursing clinics within 6 hospital settings in the United Kingdom.

      Participants: 119 patients diagnosed with small cell or non-small cell lung cancer or with mesothelioma who had completed first line treatment for their disease and reported breathlessness.

      Outcome measures: Visual analogue scales measuring distress due to breathlessness, breathlessness at best and worst, WHO performance status scale, hospital anxiety and depression scale, and Rotterdam symptom checklist.

      Results: The intervention group improved significantly at 8 weeks in 5 of the 11 items assessed: breathlessness at best, WHO performance status, levels of depression, and two Rotterdam symptom checklist measures (physical symptom distress and breathlessness) and showed slight improvement in 3 of the remaining 6 items.

      Conclusion: Most patients who completed the study had a poor prognosis, and breathlessness was typically a symptom of their deteriorating condition. Patients who attended nursing clinics and received the breathlessness intervention experienced improvements in breathlessness, performance status, and physical and emotional states relative to control patients.


      • Funding Macmillan Cancer Relief

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