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Schunk, M.* ; Le, L.* ; Syunyaeva, Z.* ; Haberland, B.* ; Tänzler, S.* ; Mansmann, U.* ; Schwarzkopf, L. ; Seidl, H. ; Streitwieser, S.* ; Hofmann, M.* ; Müller, T.* ; Weiß, T.* ; Morawietz, P.* ; Rehfuess, E.A.* ; Huber, R.M.* ; Berger, U.* ; Bausewein, C.*

Effectiveness of a specialised breathlessness service for patients with advanced disease in Germany: A pragmatic fast track randomised controlled trial (BreathEase).

Eur. Respir. J. 58:2002139 (2021)
Postprint DOI PMC
Open Access Green
Background The effectiveness of the Munich Breathlessness Service (MBS), integrating palliative care, respiratory medicine and physiotherapy, was tested in the BreathEase trial in patients with chronic breathlessness in advanced disease and their carers.Methods BreathEase was a single-blinded randomised controlled fast-track trial. The MBS was attended for 5-6 weeks; the control group started the MBS after 8 weeks of standard care. Randomisation was stratified by cancer and the presence of a carer. Primary outcomes were patients' mastery of breathlessness (Chronic Respiratory Disease Questionnaire (CRQ) Mastery), quality of life (CRQ QoL), symptom burden (Integrated Palliative care Outcome Scale (IPOS)) and carer burden (Zarit Burden Interview (ZBI)). Intention-to-treat (ITT) analyses were conducted with hierarchical testing. Effectiveness was investigated by linear regression on change scores, adjusting for baseline scores and stratification variables. Missing values were handled with multiple imputation.Results 92 patients were randomised to the intervention group and 91 patients were randomised to the control group. Before the follow-up assessment after 8 weeks (T1), 17 and five patients dropped out from the intervention and control groups, respectively. Significant improvements in CRQ Mastery of 0.367 (95% CI 0.065-0.669) and CRQ QoL of 0.226 (95% CI 0.012-0.440) score units at Ti in favour of the intervention group were seen in the ITT analyses (n=183), but not in IPOS. Exploratory testing showed nonsignificant improvements in 21311.Conclusions These findings demonstrate positive effects of the MBS in reducing burden caused by chronic breathlessness in advanced illness across a wide range of patients. Further evaluation in subgroups of patients and with a longitudinal perspective is needed.
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Publication type Article: Journal article
Document type Scientific Article
Keywords Quality-of-life; Clinical-trials; Refractory Breathlessness; Health-care; End-points; Prevalence; Caregivers; Statement; Burden; Update
Language english
Publication Year 2021
HGF-reported in Year 2021
ISSN (print) / ISBN 0903-1936
e-ISSN 1399-3003
Journal European Respiratory Journal
Quellenangaben Volume: 58, Issue: 2, Pages: , Article Number: 2002139 Supplement: ,
Publisher European Respiratory Society
Publishing Place Sheffield
Reviewing status Peer reviewed
Institute(s) Institute of Health Economics and Health Care Management (IGM)
POF-Topic(s) 30202 - Environmental Health
80000 - German Center for Lung Research
Research field(s) Genetics and Epidemiology
PSP Element(s) G-505300-001
G-501800-533
Grants BMBF (German Federal Ministry of Education and Research)
DOI 10.1183/13993003.02139-2020
WOS ID WOS:000694804400032
PubMed ID 33509957
Erfassungsdatum 2021-04-12
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