SynthesisThorax2019
Holistic services for people with advanced disease and chronic breathlessness: a systematic review and meta-analysis.
Synthesis in Thorax, 2019. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 63 papers, 7 of them syntheses that pooled it.
What it found
Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.
The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.
The trial behind it
Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.
Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.
Who cites it
63 citing papers in PubMed, 7 syntheses or guidelines pooled it, 146 citations in OpenAlex.
- Palliative care interventions for thoracic cancer: a systematic review and meta-analysis identifying the core elements.European respiratory review : an official journal of the European Respiratory Society · 2026Pooled it
- Supplemental oxygen for symptomatic relief in people with serious respiratory illness: a systematic review and meta-analysis.European respiratory review : an official journal of the European Respiratory Society · 2025Pooled it
- Multicomponent services for symptoms in serious respiratory illness: a systematic review and meta-analysis.European respiratory review : an official journal of the European Respiratory Society · 2024Pooled it
- Non-pharmacological interventions targeting mobility among people with advanced cancer: a systematic review.Supportive care in cancer : official journal of the Multinational Association of Supportive Care in Cancer · 2024Pooled it
- Which factors influence the quality of end-of-life care in interstitial lung disease? A systematic review with narrative synthesis.Palliative medicine · 2022Pooled it
- Effectiveness and implementation of palliative care interventions for patients with chronic obstructive pulmonary disease: A systematic review.Palliative medicine · 2021Pooled it
- Low-intensity educational interventions supporting self-management to improve outcomes related to chronic breathlessness: a systematic review.NPJ primary care respiratory medicine · 2019Pooled it
- Complex breathlessness intervention in idiopathic pulmonary fibrosis (BREEZE-IPF): a feasibility, wait-list design randomised controlled trial.BMJ open respiratory research · 2025Trial
- Trial
- Prevalence of loneliness and its associated factors in middle-aged and older adults with breathlessness: a nationally representative cohort study.BMJ open respiratory research · 2026Article
- Article
- A Personalized, Home-Based, Multidisciplinary Outpatient Clinic for Managing Breathlessness in Chronic Obstructive Pulmonary Disease: Protocol for a Single-Arm, Mixed-Methods Cohort Study.JMIR research protocols · 2026Article
- "Breathlessness stops me doing everything": exploring the impact of chronic breathlessness due to advanced respiratory disease and exacerbating factors - a qualitative study.ERJ open research · 2026Article
- Breathlessness Matters - Australian Cohort Study Evaluating the Impact of a Multidisciplinary, Home-Based Breathlessness Intervention Service Targeting Patients with Chronic Obstructive Pulmonary Disease (COPD).International journal of chronic obstructive pulmonary disease · 2026Article
- Implementing breathlessness self-management in low- and middle-income countries: co-design of breathlessness self-management resources for use in India.NPJ primary care respiratory medicine · 2025Article
- Translating a Home-Based Breathlessness Service: A Pilot Study of Feasibility, Person-Reported, and Hospital Use Outcomes.Journal of clinical medicine · 2025Article
- BREATHLEssness in INDIA (BREATHE-INDIA): realist review to develop explanatory programme theory about breathlessness self-management in India.NPJ primary care respiratory medicine · 2025Review
- Non-Pharmacological Management of Idiopathic Pulmonary Fibrosis.Journal of clinical medicine · 2025Review
- "I'm living in a 'no' world now…"- A qualitative study of the widespread impact of living with chronic breathlessness, and experiences of identification and assessment of this symptom in an older, frail community-based population.NPJ primary care respiratory medicine · 2025Article
- A qualitative study of the palliative care needs of primary care patients with COPD: Experiences of COPD patients, their families and healthcare professionals.Palliative care and social practice · 2025Article
3 more citing papers are in PubMed but not listed here.
Corrections and comments
PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.
Authors and funding
10 authors at 5 institutions in 1 country.
Funding
Abstract
backgroundBreathlessness is a common, distressing symptom in people with advanced disease and a marker of deterioration. Holistic services that draw on integrated palliative care have been developed for this group. This systematic review aimed to examine the outcomes, experiences and therapeutic components of these services.
methodsSystematic review searching nine databases to June 2017 for experimental, qualitative and observational studies. Eligibility and quality were independently assessed by two authors. Data on service models, health and cost outcomes were synthesised, using meta-analyses as indicated. Data on recipient experiences were synthesised thematically and integrated at the level of interpretation and reporting.
resultsFrom 3239 records identified, 37 articles were included representing 18 different services. Most services enrolled people with thoracic cancer, involved palliative care staff and comprised 4-6 contacts over 4-6 weeks. Commonly used interventions included breathing techniques, psychological support and relaxation techniques. Meta-analyses demonstrated reductions in Numeric Rating Scale distress due to breathlessness (n=324; mean difference (MD) -2.30, 95% CI -4.43 to -0.16, p=0.03) and Hospital Anxiety and Depression Scale (HADS) depression scores (n=408, MD -1.67, 95% CI -2.52 to -0.81, p<0.001) favouring the intervention. Statistically non-significant effects were observed for Chronic Respiratory Questionnaire (CRQ) mastery (n=259, MD 0.23, 95% CI -0.10 to 0.55, p=0.17) and HADS anxiety scores (n=552, MD -1.59, 95% CI -3.22 to 0.05, p=0.06). Patients and carers valued tailored education, self-management interventions and expert staff providing person-centred, dignified care. However, there was no observable effect on health status or quality of life, and mixed evidence around physical function.
conclusionHolistic services for chronic breathlessness can reduce distress in patients with advanced disease and may improve psychological outcomes of anxiety and depression. Therapeutic components of these services should be shared and integrated into clinical practice. REGISTRATION NUMBER: CRD42017057508.
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Registered trials
Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.