Management of moderate-to-severe dyspnea in hospitalized patients receiving palliative care

Context: Benzodiazepines (BZDs) are commonly prescribed for relief of dyspnea in palliative care, yet few data describe their efficacy. Objectives: To describe the management of moderate-to-severe dyspnea in palliative care patients. Methods: Chart review of inpatients with moderate or severe dyspne...

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Main Authors: Patama Gomutbutra, David L. O'Riordan, Steven Z. Pantilat
Format: Journal
Published: 2018
Online Access:https://www.scopus.com/inward/record.uri?partnerID=HzOxMe3b&scp=84877578863&origin=inward
http://cmuir.cmu.ac.th/jspui/handle/6653943832/47959
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spelling th-cmuir.6653943832-479592018-04-25T08:46:02Z Management of moderate-to-severe dyspnea in hospitalized patients receiving palliative care Patama Gomutbutra David L. O'Riordan Steven Z. Pantilat Context: Benzodiazepines (BZDs) are commonly prescribed for relief of dyspnea in palliative care, yet few data describe their efficacy. Objectives: To describe the management of moderate-to-severe dyspnea in palliative care patients. Methods: Chart review of inpatients with moderate or severe dyspnea on initial evaluation by a palliative care service. We recorded dyspnea scores at follow-up (24 hours later) and use of BZDs and opioids. Results: The records of 115 patients were reviewed. The mean age of patients was 64 years and primary diagnoses included cancer (64%, n = 73), heart failure (8%, n = 9), and chronic obstructive pulmonary disease (5%, n = 6). At initial assessment, 73% (n = 84) of the patients had moderate and 27% (n = 31) had severe dyspnea. At follow-up, 74% (n = 85) of patients reported an improvement in their dyspnea, of which 42% (n = 36) had received opioids alone, 37% (n = 31) had BZDs concurrent with opioids, 2% (n = 2) had BZDs alone, and 19% (n = 16) had received neither opioids nor BZDs. Logistic regression analysis identified that patients who received BZDs and opioids had increased odds of improved dyspnea (odds ratio 5.5, 95% CI 1.4, 21.3) compared with those receiving no medications. Conclusion: Most patients reported improvement in dyspnea at 24 hours after palliative care service consultation. Consistent with existing evidence, most patients with dyspnea received opioids but only the combination of opioids and BZDs was independently associated with improvement in dyspnea. Further research on the role of BZDs alone and in combination with opioids may lead to better treatments for this distressing symptom. © 2013 U.S. Cancer Pain Relief Committee. Published by Elsevier Inc. All rights reserved. 2018-04-25T08:46:02Z 2018-04-25T08:46:02Z 2013-05-01 Journal 18736513 08853924 2-s2.0-84877578863 10.1016/j.jpainsymman.2012.05.004 https://www.scopus.com/inward/record.uri?partnerID=HzOxMe3b&scp=84877578863&origin=inward http://cmuir.cmu.ac.th/jspui/handle/6653943832/47959
institution Chiang Mai University
building Chiang Mai University Library
country Thailand
collection CMU Intellectual Repository
description Context: Benzodiazepines (BZDs) are commonly prescribed for relief of dyspnea in palliative care, yet few data describe their efficacy. Objectives: To describe the management of moderate-to-severe dyspnea in palliative care patients. Methods: Chart review of inpatients with moderate or severe dyspnea on initial evaluation by a palliative care service. We recorded dyspnea scores at follow-up (24 hours later) and use of BZDs and opioids. Results: The records of 115 patients were reviewed. The mean age of patients was 64 years and primary diagnoses included cancer (64%, n = 73), heart failure (8%, n = 9), and chronic obstructive pulmonary disease (5%, n = 6). At initial assessment, 73% (n = 84) of the patients had moderate and 27% (n = 31) had severe dyspnea. At follow-up, 74% (n = 85) of patients reported an improvement in their dyspnea, of which 42% (n = 36) had received opioids alone, 37% (n = 31) had BZDs concurrent with opioids, 2% (n = 2) had BZDs alone, and 19% (n = 16) had received neither opioids nor BZDs. Logistic regression analysis identified that patients who received BZDs and opioids had increased odds of improved dyspnea (odds ratio 5.5, 95% CI 1.4, 21.3) compared with those receiving no medications. Conclusion: Most patients reported improvement in dyspnea at 24 hours after palliative care service consultation. Consistent with existing evidence, most patients with dyspnea received opioids but only the combination of opioids and BZDs was independently associated with improvement in dyspnea. Further research on the role of BZDs alone and in combination with opioids may lead to better treatments for this distressing symptom. © 2013 U.S. Cancer Pain Relief Committee. Published by Elsevier Inc. All rights reserved.
format Journal
author Patama Gomutbutra
David L. O'Riordan
Steven Z. Pantilat
spellingShingle Patama Gomutbutra
David L. O'Riordan
Steven Z. Pantilat
Management of moderate-to-severe dyspnea in hospitalized patients receiving palliative care
author_facet Patama Gomutbutra
David L. O'Riordan
Steven Z. Pantilat
author_sort Patama Gomutbutra
title Management of moderate-to-severe dyspnea in hospitalized patients receiving palliative care
title_short Management of moderate-to-severe dyspnea in hospitalized patients receiving palliative care
title_full Management of moderate-to-severe dyspnea in hospitalized patients receiving palliative care
title_fullStr Management of moderate-to-severe dyspnea in hospitalized patients receiving palliative care
title_full_unstemmed Management of moderate-to-severe dyspnea in hospitalized patients receiving palliative care
title_sort management of moderate-to-severe dyspnea in hospitalized patients receiving palliative care
publishDate 2018
url https://www.scopus.com/inward/record.uri?partnerID=HzOxMe3b&scp=84877578863&origin=inward
http://cmuir.cmu.ac.th/jspui/handle/6653943832/47959
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