The C.A.M. Report
Complementary and Alternative Medicine: Fair, Balanced, and to the Point
  • About this web log

    This blog is intended as an objective and dispassionate source of information on the latest CAM research. Since my background is in pharmacy and allopathic medicine, I view all CAM as advancing through the development pipeline to eventually become integrated into mainstream medical practice. Some will succeed while others fail. But all are treated fairly here.

  • About the author

    John Russo, Jr., PharmD, is president of The MedCom Resource, Inc. Previously, he was senior vice president of medical communications at www.Vicus.com, a complementary and alternative medicine website.

  • Common sense considerations

    The material on this weblog is for informational purposes. It is not medical advice or counsel. Be smart, consult your health professional before using CAM.

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    Nonpharmacological strategies for breathlessness

    Breathlessness (aka dyspnea) is difficult to manage in palliative care.

    Researchers in the UK reviewed and ranked the most effective nonpharmacological strategies.

    First, the details.

    • Evidence supports their use in breathlessness
      • Facial cooling, by handheld fan
      • Mobility aids (eg, rollators/walkers)
      • Neuromuscular electrical stimulation
    • Need definition and further research
      • Breathing exercises
      • Pacing and positioning
    • Also…
      • Anxiety reduction techniques and carer support act indirectly in chronic disease management and are applicable for breathlessness.
      • Exercise is an established strategy in both respiratory and other chronic diseases to maintain fitness (which reduces breathlessness) and increase psychological well-being.

    The bottom line?

    The authors concluded, “All patients with breathlessness should learn appropriate nonpharmacological interventions.”

    “Some can be taught by clinicians without specialist training, but others require specialist skills and high levels of engagement by cognitively intact and highly motivated people.”

    Respiratory muscle weakness is not an uncommon finding in palliative care. It can be found in various forms of neuromuscular disease such as myasthenia gravis, multiple sclerosis, or amyotrophic lateral sclerosis; with metabolic derangements such as hypokalemia or hypophosphatemia; in cases of malnutrition or ataxia; and in critical illness neuropathy.

    5/3/11 20:20 JR

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