The active identification and management of chronic refractory breathlessness is a human right

被引:63
作者
Currow, David C. [1 ]
Abernethy, Amy P. [1 ,2 ]
Ko, Danielle N. [3 ]
机构
[1] Flinders Univ S Australia, Discipline Palliat & Support Serv, Adelaide, SA 5001, Australia
[2] Duke Univ, Med Ctr, Dept Med, Div Med Oncol, Durham, NC 27710 USA
[3] Barwon Hlth, Palliat Care Program, Geelong, Vic, Australia
基金
美国医疗保健研究与质量局;
关键词
DYSPNEA; STATEMENT; DISEASE;
D O I
10.1136/thoraxjnl-2013-204701
中图分类号
R56 [呼吸系及胸部疾病];
学科分类号
摘要
Chronic refractory breathlessness is defined as breathlessness at rest or on minimal exertion that will persist chronically despite optimal treatment of the underlying cause(s). At any time, 1% of the population report a modified Medical Research Council dyspnoea score of >= 3 chronically. Despite the prevalence, severity and chronicity of this symptom and an evidence base of affordable and safe interventions, chronic refractory breathlessness remains grossly undertreated. Many patients and clinicians accept the presence of the chronic refractory breathlessness as an inevitable part of an illness, with no thought of treating the symptom despite an evidence base for its safe treatment. Consensus statements from major respiratory clinician organisations now endorse such a clinical course. Failure to enquire about, assess and properly treat chronic refractory breathlessness with opioids as outlined in specialist clinical guidelines is now an unacceptable level of care ethically and is, arguably, a breach of people's human rights. Adequate pain control through access to pain relief is now accepted as a human right and, given its burden across the world, the symptomatic treatment of chronic refractory breathlessness should be seen in exactly the same way.
引用
收藏
页码:393 / 394
页数:2
相关论文
共 12 条
[1]   Randomised, double blind, placebo controlled crossover trial of sustained release morphine for the management of refractory dyspnoea [J].
Abernethy, AP ;
Currow, DC ;
Frith, P ;
Fazekas, BS ;
McHugh, A ;
Bui, C .
BRITISH MEDICAL JOURNAL, 2003, 327 (7414) :523-526
[2]  
Brennan F, 2007, ANESTH ANALG, V105, P205, DOI 10.1213/01.ane.0000268145.52345.55
[3]   Evidence-based intervention for chronic refractory breathlessness: practical therapies that make a difference [J].
Currow, David ;
Johnson, Miriam ;
White, Patrick ;
Abernethy, Amy .
BRITISH JOURNAL OF GENERAL PRACTICE, 2013, 63 (616) :609-610
[4]   International Perspective: Outcomes of Palliative Oncology [J].
Currow, David C. ;
Wheeler, Jane L. ;
Abernethy, Amy P. .
SEMINARS IN ONCOLOGY, 2011, 38 (03) :343-350
[5]   A Community Population Survey of Prevalence and Severity of Dyspnea in Adults [J].
Currow, David C. ;
Plummer, John L. ;
Crockett, Alan ;
Cert, Grad ;
Abernethy, Amy P. .
JOURNAL OF PAIN AND SYMPTOM MANAGEMENT, 2009, 38 (04) :533-545
[6]   To What Causes Do People Attribute Their Chronic Breathlessness? A Population Survey [J].
Johnson, Miriam J. ;
Bowden, Jacqueline A. ;
Abernethy, Amy P. ;
Currow, David C. .
JOURNAL OF PALLIATIVE MEDICINE, 2012, 15 (07) :744-750
[7]   Access to pain treatment as a human right [J].
Lohman, Diederik ;
Schleifer, Rebecca ;
Amon, Joseph J. .
BMC MEDICINE, 2010, 8
[8]   American College of Chest Physicians Consensus Statement on the Management of Dyspnea in Patients With Advanced Lung or Heart Disease [J].
Mahler, Donald A. ;
Selecky, Paul A. ;
Harrod, Christopher G. ;
Benditt, Joshua O. ;
Carrieri-Kohlman, Virginia ;
Curtis, J. Randall ;
Manning, Harold L. ;
Mularski, Richard A. ;
Varkey, Basil ;
Campbell, Margaret ;
Carter, Edward R. ;
Chiong, Jun Ratunil ;
Ely, E. Wesley ;
Hansen-Flaschen, John ;
O'Donnell, Denis E. ;
Waller, Alexander .
CHEST, 2010, 137 (03) :674-691
[9]   Managing dyspnea in patients with advanced chronic obstructive pulmonary disease: A Canadian Thoracic Society clinical practice guideline [J].
Marciniuk, Darcy D. ;
Goodridge, Donna ;
Hernandez, Paul ;
Rocker, Graeme ;
Balter, Meyer ;
Bailey, Pat ;
Ford, Gordon ;
Bourbeau, Jean ;
O'Donnell, Denis E. ;
Maltais, Francois ;
Mularski, Richard A. ;
Cave, Andrew J. ;
Mayers, Irvin ;
Kennedy, Vicki ;
Oliver, Thomas K. ;
Brown, Candice .
CANADIAN RESPIRATORY JOURNAL, 2011, 18 (02) :69-78
[10]   An Official American Thoracic Society Statement: Update on the Mechanisms, Assessment, and Management of Dyspnea [J].
Parshall, Mark B. ;
Schwartzstein, Richard M. ;
Adams, Lewis ;
Banzett, Robert B. ;
Manning, Harold L. ;
Bourbeau, Jean ;
Calverley, Peter M. ;
Gift, Audrey G. ;
Harver, Andrew ;
Lareau, Suzanne C. ;
Mahler, Donald A. ;
Meek, Paula M. ;
O'Donnell, Denis E. .
AMERICAN JOURNAL OF RESPIRATORY AND CRITICAL CARE MEDICINE, 2012, 185 (04) :435-452