Managing Breathlessness in Clinical Practice

Breathlessness is increasingly recognised as a common, disabling symptom of many advanced diseases and one that is very difficult to treat. There is now an understanding that a multi-disciplinary approach to management can make a significant impact on the severity of the symptom improving both the patient’s and their carers’ quality of life.

Breathlessness is one of the most difficult conditions that palliative care (and other clinicians who care for patients with advanced disease) have to treat. With the improvements in pain control, it is possibly now the most difficult symptom for clinicians to manage: many feel frustrated at not being able to give their patients better care.  Many patients and families are enduring terrible suffering. There has been little progress in improving the symptom, in spite of an increase in the amount of research and interest in it over the last twenty years. The Cambridge Breathlessness Intervention Service (CBIS) has been established since 2004 and is a research-based service which has being evaluated since its inception: its model of caring has been shaped by the patients and families who use it and the clinicians who refer to it. CBIS has firm evidence of its effectiveness with patients with breathlessness with both malignant and non-malignant disease. This book will help others to manage breathlessness in their day-to-day clinical practice and, if so desired, set up their own breathlessness service. There is a well-established website which can be used in conjunction with the book. The book is written to give practical help in the clinical management of breathlessness and written so that the information is easy to access in clinic, ward or home.

Dr.Sara Booth founded the Cambridge Breathlessness Intervention Service (CBIS) in 2004 based on work she started some ten years earlier. Dr Booth is an experienced researcher as well as clinician and has a worldwide reputation in caring for patients with breathlessness. The CBIS concept has been copied in other parts of the world and Dr Booth has lectured at many conferences for oncologists and respiratory as well as palliative care clinicians on the management of breathlessness. Dr Booth was the first chair of the National Cancer Institute’s Breathlessness Research Group. Ms Julie Burkin is a specialist OT who has worked in hospices and cancer centres caring for breathless patients. She is now the lead clinician for CBIS and has lectured widely, nationally and internationally, on the management of breathlessness. Ms Catherine Moffat is a specialist physiotherapist who has a particular interest in breathing exercises – a poorly researched area she has made her own. Ms Moffat is designing research in this area and has also lectured widely on the work of CBIS and the management of breathlessness.