Respiratory distress symptom intervention for non-pharmacological management of the lung cancer breathlessness-cough-fatigue symptom cluster: randomised controlled trial
Johnson, M. J.
Blackhall, Fiona H
Lloyd Williams, M.
Mackereth, Peter A
AffiliationChristie Patient Centred Research, The Christie NHS Foundation Trust, Manchester, UK
MetadataShow full item record
AbstractObjectives: In lung cancer, three prominent symptoms, such as breathlessness, cough and fatigue, are closely related with each other forming a 'respiratory distress symptom cluster'. The aim of this study was to determine the clinical and cost-effectiveness of the respiratory distress symptom intervention (RDSI) for the management of this symptom cluster in people with lung cancer. Methods: A single blind, pragmatic, randomised controlled trial conducted in eight centres in England, UK. A total of 263 patients with lung cancer were randomised, including 132 who received RDSI and 131 who received standard care. To be eligible, participants self-reported adverse impact in daily life from at least two of the three symptoms, in any combination. Outcomes were change at 12 weeks for each symptom within the cluster, including Dyspnoea-12 (D-12), Manchester Cough in Lung Cancer (MCLC) and Functional Assessment of Chronic Illness-Fatigue. Results: At baseline, nearly 60% of participants reported all three symptoms. At trial completion the total trial attrition was 109 (41.4%). Compared with the control group, the RDSI group demonstrated a statistically significant improvement in D-12 (p=0.007) and MCLC (p<0.001). The minimal clinically important difference MCID) was achieved for each outcome: D-12 -4.13 (MCID >3), MCLC -5.49 (MCID >3) and FACIT-F 4.91 (MCID >4). Conclusion: RDSI is a clinically effective, low-risk intervention to support the management of the respiratory distress symptom cluster in lung cancer. However, the study did experience high attrition, which needs to be taken onto consideration when interpreting these results.
CitationYorke J, Johnson MJ, Punnett G, Smith J, Blackhall F, Lloyd Williams M, et al. Respiratory distress symptom intervention for non-pharmacological management of the lung cancer breathlessness-cough-fatigue symptom cluster: randomised controlled trial. BMJ supportive & palliative care. 2022 Oct 25. PubMed PMID: 36283797. Epub 2022/10/26. eng.
JournalBMJ Supportive and Palliative Care
- Management of the respiratory distress symptom cluster in lung cancer: a randomised controlled feasibility trial.
- Authors: Yorke J, Lloyd-Williams M, Smith J, Blackhall F, Harle A, Warden J, Ellis J, Pilling M, Haines J, Luker K, Molassiotis A
- Issue date: 2015 Nov
- Participation in a randomised controlled feasibility study of a complex intervention for the management of the Respiratory Symptom Distress Cluster in lung cancer: patient, carer and research staff views.
- Authors: Ellis J, Warden J, Molassiotis A, Mackereth P, Lloyd-Williams M, Bailey C, Burns K, Yorke J
- Issue date: 2017 Nov
- Telephone interventions for symptom management in adults with cancer.
- Authors: Ream E, Hughes AE, Cox A, Skarparis K, Richardson A, Pedersen VH, Wiseman T, Forbes A, Bryant A
- Issue date: 2020 Jun 2
- The Effectiveness of Qigong in Managing a Cluster of Symptoms (Breathlessness-Fatigue-Anxiety) in Patients with Lung Cancer: A Randomized Controlled Trial.
- Authors: Molassiotis A, Vu DV, Ching SSY
- Issue date: 2021 Jan-Dec