The Effects Of Non Pharmacological Interventions On - amazonia.fiocruz.br

Either your web browser doesn't support Javascript or it is currently turned off. In the latter case, please turn on Javascript support in Pharkacological web browser and reload this page. We assessed efficacy and effectiveness of pharmacological and nonpharmacological interventions in improving symptom control, functional exercise capacity and quality of life QoL in people living with fibrotic interstitial lung disease ILD. We summarised evidence from three previous reviews to June and conducted an updated search of nine databases and grey literature — registration: CRD for prospective studies of interventions aimed to alleviate symptoms, improve QoL or functional exercise capacity in fibrotic ILD.

Data were synthesised through narrative synthesis or meta-analysed as appropriate. Forty-seven studies with participants were included.

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Multiple, varied outcome measures were used e. Evidence gap mapping highlighted the most and least researched symptoms, as dyspnoea and cough, respectively. This evidence synthesis highlights overwhelmingly that the most researched symptom is dyspnoea and the strongest evidence base is for short-term PR. The least researched symptom was cough. Research going forward must focus on prioritising and standardising meaningful outcomes and focussing interventions on neglected symptoms. Cough is a neglected symptom in ILD. Future research must prioritise and standardise meaningful outcomes, and focus interventions on neglected symptoms while ensuring dyspnoea is prioritised as a primary end-point The Effects Of Non Pharmacological Interventions On future studies. However, fibrotic ILDs such as idiopathic pulmonary fibrosis IPF have a shorter disease trajectory, which can be rapidly advancing [ 1 ].

The resulting physical and psychological burden with impact on quality of life QoL can be substantial for both patients and carers [ 2 ]. Essential to achieving this is to improve symptom management and QoL as well as improving functional exercise capacity.

Short abstract

Previous systematic reviews have summarised interventions to improve symptoms and QoL in ILD [ 4 — 6 ] see online supplement 1 for further details. As the importance of improving the symptoms, functional exercise capacity and QoL of The Effects Of Non Pharmacological Interventions On patients has become increasingly recognised [ 78 ], there has been a surge in intervention studies. There is therefore a need to synthesise previous research with more recently published studies and highlight areas in which we may move research forward in a meaningful way. We aimed to synthesise relevant studies from three previous systematic reviews with more recently published studies and highlight gaps in research through an evidence gap map. The protocol stated that participants with continue reading confirmed diagnosis of ILD would be included.

However, after reflection within the Project Advisory Team, to limit heterogeneity, it was decided to focus on fibrotic ILDs only as they all shared the commonality of shorter disease trajectory, severity of symptoms and poor functional exercise capacity. We excluded studies in people with connective tissue ILDs or obstructive sleep apnoea and those for which the breakdown of ILD diagnoses was not available. Eligible interventions were any pharmacological or nonpharmacological intervention aimed at managing symptoms or improving QoL such as oxygen therapy, opioids, corticosteroids and noninvasive ventilation or functional exercise capacity as measured by 6-min walk distance 6MWD.

Introduction

Radical disease modifying interventions, that were evaluated in studies primarily focused on improving survival and lung function, were deemed out of scope. Eligible Phwrmacological were all symptom control outcomes such as breathlessness, cough and fatigueQoL outcomes and 6MWD. Prospective efficacy and effectiveness studies of any design were eligible including observational e. Two authors AO and SB independently screened studies that were included in the previous reviews [ 4 — 6 ] for inclusion.

Reference lists of included studies were screened and experts in the field contacted to identify additional studies.]