Impact of an Interdisciplinary Approach to the Management of Refractory Dyspnoea on Patient Quality of Life by a Non-Palliative Respiratory Care Team: A Pilot Study.

INTRODUCTION

Refractory dyspnoea is a common symptom of chronic respiratory disease, often poorly recognized by healthcare professionals. Pharmacological treatments are of limited effectiveness. A multidisciplinary intervention carried out by a specialized palliative care team has demonstrated its effectiveness in helping patients improve their quality of life. The aim of this pilot study was to verify the effects of a multidisciplinary intervention carried out by a team not specialized in palliative care (physician, psychologist, physiotherapist, social worker, dietician).

METHODS

A longitudinal, single-arm interventional study was conducted between February 2019 and May 2022. All consecutive patients with refractory dyspnoea - referred by a pulmonologist - had a non-pharmacological paramedical intervention (ventilatory education, mindfulness meditation, respiratory rehabilitation, psychological and dietary support, etc.) tailored to their situation after an initial interview. The primary endpoint was the evolution of the Chronic Respiratory Questionnaire (CRQ) before and after the intervention.

RESULTS

Fifty-eight patients were referred; 56 patients underwent the intervention. Patients were comparable to previous studies on the basis of LCADL and ESAS scores. The CRQ increased from 4.7 ± 1.5 to 6.2 ± 1.5 pre- and post-intervention overall (p < 0.001), with a significant change in all sub-items (fatigue, dyspnoea, emotional function, control).

CONCLUSION

A non-specialized multidisciplinary palliative care team can help patients with refractory dyspnoea improve their quality of life.