Management of refractory breathlessness in patients with advanced disease

Background. Breathlessness is a frequent and distressing symptom in advanced disease. It can have a significant impact on the quality of life of both patients and relatives. Objectives. A summary of nonpharmacological and pharmacological measures for breathlessness based on existing evidence is provided. Materials and methods. Analysis of primary studies, reviews and guidelines for the named symptoms and their management were analyzed. Results. Recognition and assessment are essential for the management of breathlessness. Management includes various nonpharmacological and pharmacological measures, which should be combined for best results. Nonpharmacological strategies comprise general information, management plan, hand-held fan, physical activity, and rollators. Opioids are the drugs of choice for intractable breathlessness. The evidence base for benzodiazepines and other drugs is rather weak. Conclusion. A number of treatment options, especially in the nonpharmacological area, help the patients to better cope with their breathlessness.