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  1. Article ; Online: Understanding persistent breathlessness: impact on patients and optimal approaches to symptomatic reduction - an overview.

    Ferreira, Diana H / Kochovska, Slavica / Brunelli, Vanessa N / Currow, David C

    Expert review of respiratory medicine

    2023  Volume 17, Issue 5, Page(s) 365–379

    Abstract: Introduction: Persistent breathlessness (breathlessness persisting despite optimal treatment for the underlying condition and resulting in disability) is a prevalent syndrome associated with chronic and life-limiting conditions. Improving the clinical ... ...

    Abstract Introduction: Persistent breathlessness (breathlessness persisting despite optimal treatment for the underlying condition and resulting in disability) is a prevalent syndrome associated with chronic and life-limiting conditions. Improving the clinical recognition and assessment of persistent breathlessness is essential to ensure people are provided with the best treatment for optimal symptom control.
    Areas covered: This overview focuses on the impact of persistent breathlessness on patients, carers and the health system. It highlights the importance of identifying persistent breathlessness in clinical consultations, suggests steps to recognize this syndrome and discusses the evidence for non-pharmacological and pharmacological treatments in this context. Future research directions are also suggested.
    Expert opinion: Persistent breathlessness is often invisible because 1) people may not engage with the health system and 2) both clinicians and patients are reluctant to discuss breathlessness in clinical consultations. Improving the recognition and assessment of this syndrome is critical to facilitate meaningful conversations between patients and clinicians and ensure patient-centered care. Non-pharmacological strategies are key to improving symptom management and health outcomes. Regular, low-dose, sustained-release morphine may help further reduce breathlessness in people who remain symptomatic despite disease-specific and non-pharmacological therapies.
    MeSH term(s) Humans ; Dyspnea/etiology ; Palliative Care/methods
    Language English
    Publishing date 2023-05-04
    Publishing country England
    Document type Journal Article ; Review
    ZDB-ID 2479146-5
    ISSN 1747-6356 ; 1747-6348
    ISSN (online) 1747-6356
    ISSN 1747-6348
    DOI 10.1080/17476348.2023.2208348
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  2. Article ; Online: Change in persisting breathlessness during treatment with regular, low-dose, sustained-release morphine.

    Ferreira, Diana H / Ekström, Magnus / Currow, David C

    Internal medicine journal

    2022  Volume 52, Issue 10, Page(s) 1845–1846

    MeSH term(s) Humans ; Morphine/adverse effects ; Delayed-Action Preparations ; Dyspnea/drug therapy ; Dyspnea/etiology ; Analgesics, Opioid/adverse effects ; Double-Blind Method
    Chemical Substances Morphine (76I7G6D29C) ; Delayed-Action Preparations ; Analgesics, Opioid
    Language English
    Publishing date 2022-09-28
    Publishing country Australia
    Document type Letter ; Comment
    ZDB-ID 2045436-3
    ISSN 1445-5994 ; 1444-0903
    ISSN (online) 1445-5994
    ISSN 1444-0903
    DOI 10.1111/imj.15902
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  3. Article: Is being able to walk to the letterbox life-changing? A qualitative assessment of measures of improvement in persistent breathlessness.

    Ferreira, Diana H / Ekström, Magnus / Verberkt, Cornelia / Janssen, Daisy J A / Currow, David C

    ERJ open research

    2023  Volume 9, Issue 2

    Abstract: Exploring clinically meaningful measures of improvement for people with persisting ... ...

    Abstract Exploring clinically meaningful measures of improvement for people with persisting breathlessness
    Language English
    Publishing date 2023-03-06
    Publishing country England
    Document type Journal Article
    ZDB-ID 2827830-6
    ISSN 2312-0541
    ISSN 2312-0541
    DOI 10.1183/23120541.00530-2022
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  4. Article ; Online: Minimally Clinically Important Improvements (MCII) and Worsening (MCIW) in Symptoms.

    Ferreira, Diana H / Ekström, Magnus / Huang, Chao / Currow, David C

    Journal of pain and symptom management

    2022  Volume 64, Issue 2, Page(s) e107–e108

    MeSH term(s) Humans ; Patient Satisfaction ; Treatment Outcome
    Language English
    Publishing date 2022-04-14
    Publishing country United States
    Document type Letter
    ZDB-ID 639142-4
    ISSN 1873-6513 ; 0885-3924
    ISSN (online) 1873-6513
    ISSN 0885-3924
    DOI 10.1016/j.jpainsymman.2022.04.169
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  5. Article ; Online: Regular, low-dose, sustained-release morphine for persisting breathlessness in interstitial lung disease: a randomised, double-blind, placebo-controlled, crossover trial.

    Ferreira, Diana H / Ekström, Magnus / Bajwah, Sabrina / Fazekas, Belinda / Currow, David C

    The European respiratory journal

    2023  Volume 62, Issue 3

    MeSH term(s) Humans ; Morphine/therapeutic use ; Delayed-Action Preparations/therapeutic use ; Cross-Over Studies ; Dyspnea/drug therapy ; Dyspnea/etiology ; Double-Blind Method ; Lung Diseases, Interstitial/complications ; Lung Diseases, Interstitial/drug therapy ; Treatment Outcome
    Chemical Substances Morphine (76I7G6D29C) ; Delayed-Action Preparations
    Language English
    Publishing date 2023-09-28
    Publishing country England
    Document type Randomized Controlled Trial ; Letter ; Research Support, Non-U.S. Gov't
    ZDB-ID 639359-7
    ISSN 1399-3003 ; 0903-1936
    ISSN (online) 1399-3003
    ISSN 0903-1936
    DOI 10.1183/13993003.00702-2023
    Database MEDical Literature Analysis and Retrieval System OnLINE

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  6. Article ; Online: Testosterone Levels in People Taking Regular Low-Dose Sustained-Release Morphine for Persisting Breathlessness: An Exploratory Study.

    Ferreira, Diana H / Ekström, Magnus / Fazekas, Belinda / Currow, David C

    Journal of palliative medicine

    2022  Volume 26, Issue 3, Page(s) 402–405

    Abstract: Background: ...

    Abstract Background:
    MeSH term(s) Male ; Humans ; Morphine/therapeutic use ; Delayed-Action Preparations/therapeutic use ; Double-Blind Method ; Dyspnea/drug therapy ; Pulmonary Disease, Chronic Obstructive/drug therapy ; Testosterone/therapeutic use ; Analgesics, Opioid/therapeutic use
    Chemical Substances Morphine (76I7G6D29C) ; Delayed-Action Preparations ; Testosterone (3XMK78S47O) ; Analgesics, Opioid
    Language English
    Publishing date 2022-11-17
    Publishing country United States
    Document type Randomized Controlled Trial ; Journal Article ; Research Support, Non-U.S. Gov't
    ZDB-ID 1427361-5
    ISSN 1557-7740 ; 1096-6218
    ISSN (online) 1557-7740
    ISSN 1096-6218
    DOI 10.1089/jpm.2022.0381
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  7. Article ; Online: Current pharmacological strategies for symptomatic reduction of persistent breathlessness - a literature review.

    Ferreira, Diana H / Kochovska, Slavica / McNeill, Richard / Currow, David C

    Expert opinion on pharmacotherapy

    2022  Volume 24, Issue 2, Page(s) 233–244

    Abstract: Introduction: Persistent breathlessness is a debilitating symptom that is prevalent in the community, particularly in people with chronic and life-limiting illnesses. Treatment includes different steps, including pharmacological treatment aiming to ... ...

    Abstract Introduction: Persistent breathlessness is a debilitating symptom that is prevalent in the community, particularly in people with chronic and life-limiting illnesses. Treatment includes different steps, including pharmacological treatment aiming to improve the symptom and optimize people's wellbeing.
    Areas covered: PubMed and Google Scholar were screened using 'chronic breathlessness' OR 'persistent breathlessness,' AND 'pharmacological treatment,' OR 'opioids.' This review focuses on pharmacological treatments to reduce persistent breathlessness and discusses possible mechanisms involved in the process of breathlessness reduction through pharmacotherapy. Research gaps in the field of persistent breathlessness research are outlined, and future research directions are suggested.
    Expert opinion: Regular, low-dose (≤30 mg/day), sustained-release morphine is recommended as the first-line pharmacological treatment for persistent breathlessness. Inter-individual variation in response needs to be investigated in future studies in order to optimize clinical outcomes. This includes 1) better understanding the centrally mediated mechanisms associated with persisting breathlessness and response to pharmacological therapies, 2) understanding benefit from the perspective of people experiencing persistent breathlessness, small and meaningful gains in physical activity.
    MeSH term(s) Humans ; Pulmonary Disease, Chronic Obstructive/drug therapy ; Dyspnea/drug therapy ; Dyspnea/etiology ; Morphine/therapeutic use ; Analgesics, Opioid/therapeutic use ; Exercise
    Chemical Substances Morphine (76I7G6D29C) ; Analgesics, Opioid
    Language English
    Publishing date 2022-12-28
    Publishing country England
    Document type Review ; Journal Article
    ZDB-ID 2001535-5
    ISSN 1744-7666 ; 1465-6566
    ISSN (online) 1744-7666
    ISSN 1465-6566
    DOI 10.1080/14656566.2022.2160239
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    Zs.A 5130: Show issues Location:
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  8. Article ; Online: The effect of regular, low-dose, sustained-release morphine on routine physical activity in people with persistent breathlessness: a hypothesis-generating study.

    Ferreira, Diana H / Johnson, Miriam J / Janssen, Daisy J A / Ekström, Magnus / Currow, David C

    The European respiratory journal

    2022  Volume 60, Issue 6

    MeSH term(s) Humans ; Morphine/therapeutic use ; Delayed-Action Preparations/therapeutic use ; Dyspnea/drug therapy ; Analgesics, Opioid/therapeutic use ; Exercise
    Chemical Substances Morphine (76I7G6D29C) ; Delayed-Action Preparations ; Analgesics, Opioid
    Language English
    Publishing date 2022-12-08
    Publishing country England
    Document type Letter
    ZDB-ID 639359-7
    ISSN 1399-3003 ; 0903-1936
    ISSN (online) 1399-3003
    ISSN 0903-1936
    DOI 10.1183/13993003.01484-2022
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  9. Article ; Online: Perspectives on palliative oxygen for breathlessness: systematic review and meta-synthesis.

    Kochovska, Slavica / Ferreira, Diana H / Garcia, Maja V / Phillips, Jane L / Currow, David C

    The European respiratory journal

    2021  Volume 58, Issue 4

    Abstract: Oxygen therapy is frequently prescribed for the palliation of breathlessness, despite lack of evidence for its effectiveness in people who are not hypoxaemic. This study aimed to compare and contrast patients', caregivers' and clinicians' experiences of ... ...

    Abstract Oxygen therapy is frequently prescribed for the palliation of breathlessness, despite lack of evidence for its effectiveness in people who are not hypoxaemic. This study aimed to compare and contrast patients', caregivers' and clinicians' experiences of palliative oxygen use for the relief of chronic breathlessness in people with advanced life-limiting illnesses, and how this shapes prescribing.A systematic review and meta-synthesis of qualitative data was conducted. MEDLINE, CINAHL and PsycINFO were searched for peer-reviewed studies in English (2000-April 2019) reporting perspectives on palliative oxygen use for reducing breathlessness in people with advanced illnesses in any healthcare setting. After data extraction, thematic synthesis used line-by-line coding of raw data (quotes) to generate descriptive and analytical themes.Of 457 articles identified, 22 met the inclusion criteria by reporting perspectives of patients (n=337), caregivers (n=91) or clinicians (n=616). Themes common to these perspectives were: 1) benefits and burdens of palliative oxygen use, 2) knowledge and perceptions of palliative oxygen use beyond the guidelines, and 3) longitudinal trajectories of palliative oxygen use.There are differing perceptions regarding the benefits and burdens of using palliative oxygen. Clinicians should be aware that oxygen use may generate differing goals of therapy for patients and caregivers. These perceptions should be taken into consideration when prescribing oxygen for the symptomatic relief of chronic breathlessness in patients who do not quality for long-term oxygen therapy.
    MeSH term(s) Caregivers ; Dyspnea/therapy ; Humans ; Oxygen ; Oxygen Inhalation Therapy ; Palliative Care
    Chemical Substances Oxygen (S88TT14065)
    Language English
    Publishing date 2021-10-07
    Publishing country England
    Document type Journal Article ; Research Support, Non-U.S. Gov't ; Systematic Review
    ZDB-ID 639359-7
    ISSN 1399-3003 ; 0903-1936
    ISSN (online) 1399-3003
    ISSN 0903-1936
    DOI 10.1183/13993003.04613-2020
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  10. Article: Earlier multidisciplinary palliative care intervention for people with lung cancer: a systematic review and meta-analysis.

    Kochovska, Slavica / Ferreira, Diana H / Luckett, Tim / Phillips, Jane L / Currow, David C

    Translational lung cancer research

    2020  Volume 9, Issue 4, Page(s) 1699–1709

    Abstract: Lung cancer is the most common cancer and leading cause of cancer mortality globally. Lung cancer is associated with significant morbidity, with symptoms often being poorly managed, causing significant symptom burden for both patients and their family ... ...

    Abstract Lung cancer is the most common cancer and leading cause of cancer mortality globally. Lung cancer is associated with significant morbidity, with symptoms often being poorly managed, causing significant symptom burden for both patients and their family caregivers. In people with life-limiting illnesses including advanced cancer, palliative care has been effective in improving symptom control, physical and mental wellbeing, quality of life, and survivorship; with benefits extending to caregivers while in the role and subsequently. Earlier integration of palliative care within oncology may be associated with improved patient outcomes, and has been supported by two Lancet commissions and national guidelines. The evidence for its effectiveness, however, has been mixed across the cancer spectrum. The aim of this review was to evaluate the current evidence for the effectiveness of early integrated palliative care in improving outcomes for people with lung cancer and their caregivers. Meta-analyses were performed where studies used the same measure. Otherwise, synthesis used a narrative approach. Similar to other types of advanced cancer, this review reveals mixed evidence for the effectiveness of early referral to palliative care and for the effectiveness of individual palliative interventions for people with lung cancer and their caregivers. Evidence that on-demand palliative care is equally, if not more effective than palliative care that is routinely provided, raises the question whether initiation and provision of palliative care as part of multidisciplinary lung cancer care ought to be guided by an early referral or need-based referral. Better understanding of what constitutes palliative care when delivered to people with lung cancer and their caregivers will help delineate the correlation with reported outcomes for these populations.
    Language English
    Publishing date 2020-09-05
    Publishing country China
    Document type Journal Article ; Review
    ZDB-ID 2754335-3
    ISSN 2226-4477 ; 2218-6751
    ISSN (online) 2226-4477
    ISSN 2218-6751
    DOI 10.21037/tlcr.2019.12.18
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