Cognitive and Behavioral Intervention for the Management of Episodic Breathlessness in Patients With Advanced Disease

Summary

Episodic breathlessness is a common and distressing symptom in patients with advanced disease such as cancer, chronic obstructive pulmonary disease (COPD) and chronic heart failure. Since the short duration of the majority of breathless episodes limits the effectiveness of pharmacological interventions (e.g. opioids), non-pharmacological management strategies play a major role. As non-pharmacological strategies patients use, for example, cognitive and behavioural methods such as breathing or relaxation techniques.

The aim of the study is to test a brief cognitive and behavioural intervention for an improved management of episodic breathlessness. Initially, a Delphi procedure with international experts has been used to develop the brief intervention consisting of various non-pharmacological strategies to enhance the management of breathless episodes.

In the single-arm therapeutic exploratory trial (phase II), the feasibility and potential effects of the brief intervention, such as patient-reported breathlessness mastery, episodic breathlessness characteristics, quality of life, symptom burden, caregivers' burden, and breathlessness in general will be examined. The results of the study form the basis for planning and implementing a subsequent confirmatory randomized control trial (phase III).

Conditions

• Dyspnea
• Respiratory Insufficiency
• Neoplasms
• Pulmonary Disease, Chronic Obstructive
• Lung Diseases
• Heart Failure
• Lung Diseases, Interstitial
• Palliative Care
• Palliative Medicine
• Breathlessness

Interventions

BEHAVIORAL

Cognitive and Behavioral intervention for the Management of Episodic Breathlessness

The cognitive and behavioral brief intervention comprises two parts: In a first module, the intervention and the study team is introduced, the definition of episodic breathlessness is given and the individual characteristics of breathlessness episodes are recorded. Goals of the intervention are discussed. In a subsequent module on patient education and the strategies, the patient and intervention executor discuss the patients' assumptions about episodic breathlessness including triggers and already used management strategies for breathlessness episodes. This follows the presentation of the non-pharmacological strategies: movement of air/ handheld fan, forward lean, diaphragmatic breathing, distraction, pursed lips breathing, long breaths out and relaxation training. The patient selects 2-3 strategies and trains them with the intervention executor.

Sponsors & Collaborators

• University Hospital of Cologne

  collaborator OTHER

• Bethanien Krankenhaus gGmbH

  collaborator OTHER

• University of Cologne

  lead OTHER

Principal Investigators

• Steffen Simon, Prof., M.Sc. · Center of palliative medicine

Study Design

Allocation

NA

Purpose

OTHER

Masking

NONE

Model

SINGLE_GROUP

Eligibility

Min Age

18 Years

Sex

ALL

Healthy Volunteers

No

Timeline & Regulatory

Start

2019-02-09

Primary Completion

2020-03-01

Completion

2020-03-15

Countries

• Germany

Study Locations