Abstract
Oxygen therapy is frequently prescribed for the palliation of breathlessness, despite lack of evidence for its effectiveness in people who are not hypoxaemic. This study aimed to compare and contrast patients’, caregivers’ and clinicians’ experiences of palliative oxygen use for the relief of chronic breathlessness in people with advanced life-limiting illnesses, and how this shapes prescribing.
A systematic review and meta-synthesis of qualitative data was conducted. MEDLINE, CINAHL and PsycINFO were searched for peer-reviewed studies in English (2000–April 2019) reporting perspectives on palliative oxygen use for reducing breathlessness in people with advanced illnesses in any healthcare setting. After data extraction, thematic synthesis used line-by-line coding of raw data (quotes) to generate descriptive and analytical themes.
Of 457 articles identified, 22 met the inclusion criteria by reporting perspectives of patients (n=337), caregivers (n=91) or clinicians (n=616). Themes common to these perspectives were: 1) benefits and burdens of palliative oxygen use, 2) knowledge and perceptions of palliative oxygen use beyond the guidelines, and 3) longitudinal trajectories of palliative oxygen use.
There are differing perceptions regarding the benefits and burdens of using palliative oxygen. Clinicians should be aware that oxygen use may generate differing goals of therapy for patients and caregivers. These perceptions should be taken into consideration when prescribing oxygen for the symptomatic relief of chronic breathlessness in patients who do not quality for long-term oxygen therapy.
Abstract
Patients’, caregivers’ and clinicians’ differing perceptions of the benefits and burdens of palliative oxygen should be considered when defining the goals of therapy and determining clinically relevant interventions offered for chronic breathlessness http://bit.ly/2ZE285P
Footnotes
This study is registered at PROSPERO with identifier number CRD42019140813.
This article has an editorial commentary: https://doi.org/10.1183/13993003.00775-2021
This article has supplementary material available from erj.ersjournals.com
Author contributions: All authors contributed to the design and conduct of this study.
Conflict of interest: S. Kochovska has nothing to disclose.
Conflict of interest: D.H. Ferreira has nothing to disclose.
Conflict of interest: M.V. Garcia has nothing to disclose.
Conflict of interest: J.L. Phillips has nothing to disclose.
Conflict of interest: D.C. Currow is an unpaid advisory board member for Helsinn Pharmaceuticals, is a paid consultant and receives payment for intellectual property with Mayne Pharma, and is a consultant with Specialised Therapeutics Australia Pty Ltd.
Support statement: This research was funded by discretionary funds held by the academic team at IMPACCT, University of Technology Sydney (Sydney, Australia). Funding information for this article has been deposited with the Crossref Funder Registry.
- Received September 24, 2020.
- Accepted February 15, 2021.
- Copyright ©The authors 2021. For reproduction rights and permissions contact permissions{at}ersnet.org