Low-intensity educational interventions supporting self-management to improve outcomes related to chronic breathlessness: a systematic review

Raymond, Bronwyn; Johnson, Miriam; Luckett, Tim; Hutchinson, Ann; Lovell, Melanie; Phillips, Jane

Abstract

Chronic breathlessness is debilitating and frightening, often resulting in emergency department presentations with acute-on-chronic breathlessness. Self-management is complex, involving 14 components as identified by the Practical Systematic Review in Self-Management Support (PRISMS). Low-intensity educational interventions that support breathlessness self-management through written/visual educational materials, alongside limited health professional support, are available. Our aim was to describe components of low-intensity educational interventions that support and improve self-management for adults with chronic breathlessness and evaluate their efficacy for improving breathlessness-related outcomes. A systematic review was conducted, including RCTs that compared these interventions with usual care in adults with chronic disease. Synthesis took a narrative approach utilizing the PRISMS taxonomy and Template for Intervention Description and Replication (TIDieR) checklist. Of the 1948 articles identified, 7 met criteria reporting 7 RCTs using 6 interventions. Studies utilized 12 out of 14 PRISMS components, the most frequent being training/rehearsal for psychological strategies. Evidence for effectiveness was inconsistent and attempts to identify beneficial components were confounded by intervention complexity and heterogeneity. The optimal content and delivery of low-intensity educational interventions that support self-management to improve chronic breathlessness-related outcomes in adults cannot be defined from current published literature. Future research should incorporate more detailed, standardized reporting to enable comparison and meta-analysis.

Citation

Raymond, B., Johnson, M., Luckett, T., Hutchinson, A., Lovell, M., & Phillips, J. (2019). Low-intensity educational interventions supporting self-management to improve outcomes related to chronic breathlessness: a systematic review. NPJ Primary Care Respiratory Medicine, 29(1), Article 41. https://doi.org/10.1038/s41533-019-0152-8

• Journal Article Type: Review
• Acceptance Date: Oct 29, 2019
• Online Publication Date: Nov 29, 2019
• Publication Date: Dec 1, 2019
• Deposit Date: Jan 15, 2020
• Publicly Available Date: Jan 15, 2020
• Journal: npj Primary Care Respiratory Medicine
• Electronic ISSN: 2055-1010
• Publisher: Nature Publishing Group
• Peer Reviewed: Peer Reviewed
• Volume: 29
• Issue: 1
• Article Number: 41
• DOI: https://doi.org/10.1038/s41533-019-0152-8
• Keywords: Patient education; Quality of life
• Public URL: https://hull-repository.worktribe.com/output/3033884
• Contract Date: Jan 15, 2020