Non-medical devices for chronic breathlessness: use, barriers and facilitators for patients, carers and clinicians - a scoping review

Prihartadi, Aliya Syahreni; Impelliziere Licastro, Giovanna; Pearson, Mark; Johnson, Miriam J.; Luckett, Tim; Swan, Flavia

Abstract

Background: Non-medical devices such as the handheld fan (fan), mobility aids (wheeled walkers with seats) and inspiratory muscle training (IMT) devices offer benefits for patient management of chronic breathlessness. We examined the published evidence regarding patient, carer and clinician use of the fan, mobility aids and IMT devices for chronic breathlessness management, and the potential barriers and facilitators to day-to-day use in a range of settings. Methods: MEDLINE, Embase, Scopus, EBSCO and the Cochrane Database of Systematic Reviews were searched. Papers were imported into EndNote and Rayyan for review against a priori eligibility criteria. Outcome data relevant to use were extracted and categorised as potential barriers and facilitators, and a narrative synthesis exploring reasons for similarities and differences conducted. Results: Seven studies met the inclusion criteria (n=5 fan, n=2 mobility aids and n=0 IMT devices). All of the studies presented patient use of non-medical devices only. Patients found the fan easy to use at home. Mobility aids were used mainly for outdoor activities. Outdoor use for both devices were associated with embarrassment. Key barriers included: Appearance; credibility; self-stigma; technical specifications. Common facilitators were ease of use, clinical benefit and feeling safe with the device. Conclusion: The efforts of patients, carers and clinicians to adopt and use non-medical devices for the management of chronic breathlessness is impeded by lack of implementation research. Future research should improve knowledge of the barriers and facilitators to use. This would enhance understanding of how decision-making in patient-carer-clinician triads impacts on non-medical devices use for breathlessness management.

Citation

Prihartadi, A. S., Impelliziere Licastro, G., Pearson, M., Johnson, M. J., Luckett, T., & Swan, F. (in press). Non-medical devices for chronic breathlessness: use, barriers and facilitators for patients, carers and clinicians - a scoping review. BMJ Supportive & Palliative Care, https://doi.org/10.1136/bmjspcare-2021-002962

• Journal Article Type: Review
• Acceptance Date: Jun 10, 2021
• Online Publication Date: Jul 2, 2021
• Deposit Date: Jul 7, 2021
• Publicly Available Date: Jul 9, 2021
• Journal: BMJ Supportive and Palliative Care
• Print ISSN: 2045-435X
• Electronic ISSN: 2045-4368
• Publisher: BMJ Publishing Group
• Peer Reviewed: Peer Reviewed
• DOI: https://doi.org/10.1136/bmjspcare-2021-002962
• Keywords: Medicine (miscellaneous); Oncology(nursing); Medical–Surgical; General Medicine
• Public URL: https://hull-repository.worktribe.com/output/3800738