Published on: November 25, 2014

Refractory breathlessness, i.e. breathlessness that continues despite optimal treatment of the underlying condition is common in patients with advanced disease; however, clinicians struggle to manage/palliate this symptom effectively.

In response to an unmet need, Dr Charles Reilly, (Consultant Physiotherapist in Chronic Respiratory Disease, King’s College Hospital NHS Foundation Trust) Prof Claudia Bausewein, (Professor of Palliative Medicine, Munich University Hospital, Germany) and Prof Irene Higginson, (Professor of Palliative Care and Policy, King’s College London; Director of the Cicely Saunders Institute, London, UK) developed an innovative integrated Palliative Care, Respiratory Medicine and Physiotherapy service known as the Breathlessness Support Service (BSS) to address the needs of these complex patients.

A patient who received the BSS described it as follows:

“The blissful thing is, you can control your breathing, if you get a bad spell you can work your way through it whereas previously when I was choking I really didn’t know what to do”. (Man with ILD – interstitial lung disease).

This is the first study demonstrating the benefit of early integration of palliative care for patients with advanced chronic respiratory disease, who traditionally may not easily get access to palliative care.

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