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  • Non-medical devices for chronic breathlessness: use, barriers and facilitators for patients, carers and clinicians - a scoping review

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Non-medical devices for chronic breathlessness: use, barriers and facilitators for patients, carers and clinicians - a scoping review
  1. Aliya Syahreni Prihartadi1,
  2. Giovanna Impelliziere Licastro1,
  3. Mark Pearson1,
  4. Miriam J Johnson1,
  5. Tim Luckett2 and
  6. Flavia Swan1
  1. 1 Wolfson Palliative Care Research Centre, Hull York Medical School, University of Hull, Hull, UK
  2. 2 Faculty of Health, University of Technology Sydney, Sydney, New South Wales, Australia
  1. Correspondence to Dr Flavia Swan, Wolfson Palliative Care Research Centre, University of Hull, Hull, HU6 7RX, UK; flavia.swan{at}hyms.ac.uk

Abstract

Background Non-medical devices such as the handheld fan (fan), mobility aids (wheeled walkers with seats) and inspiratory muscle training (IMT) devices offer benefits for patient management of chronic breathlessness. We examined the published evidence regarding patient, carer and clinician use of the fan, mobility aids and IMT devices for chronic breathlessness management, and the potential barriers and facilitators to day-to-day use in a range of settings.

Methods MEDLINE, Embase, Scopus, EBSCO and the Cochrane Database of Systematic Reviews were searched. Papers were imported into EndNote and Rayyan for review against a priori eligibility criteria. Outcome data relevant to use were extracted and categorised as potential barriers and facilitators, and a narrative synthesis exploring reasons for similarities and differences conducted.

Results Seven studies met the inclusion criteria (n=5 fan, n=2 mobility aids and n=0 IMT devices). All of the studies presented patient use of non-medical devices only. Patients found the fan easy to use at home. Mobility aids were used mainly for outdoor activities. Outdoor use for both devices were associated with embarrassment. Key barriers included: appearance; credibility; self-stigma; technical specifications. Common facilitators were ease of use, clinical benefit and feeling safe with the device.

Conclusion The efforts of patients, carers and clinicians to adopt and use non-medical devices for the management of chronic breathlessness is impeded by lack of implementation research. Future research should improve knowledge of the barriers and facilitators to use. This would enhance understanding of how decision-making in patient–carer–clinician triads impacts on non-medical devices use for breathlessness management.

  • dyspnoea
  • chronic conditions

https://doi.org/10.1136/bmjspcare-2021-002962

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    Footnotes

    • Twitter @HSRMarkP, @MJJohnson_HYMS, @swanflavia

    • Contributors FS and MP created the concept and design of the study. FS and ASP created the search strategies. ASP and GIL conducted the searches and screened records. ASP, GIL and FS extracted the data. FS and ASP interpreted and analysed the data. FS, ASP and MP prepared the manuscript. FS, ASP, GIL, MP, MJJ and TL edited and reviewed the final manuscript. FS is responsible for the overall content.

    • Funding This work was supported by the INSPIRE grant generously awarded to Hull York Medical School by the Academy of Medical Sciences through the Wellcome Trust (Ref: IR5\1018).

    • Competing interests None declared.

    • Provenance and peer review Not commissioned; externally peer reviewed.

    • Supplemental material This content has been supplied by the author(s). It has not been vetted by BMJ Publishing Group Limited (BMJ) and may not have been peer-reviewed. Any opinions or recommendations discussed are solely those of the author(s) and are not endorsed by BMJ. BMJ disclaims all liability and responsibility arising from any reliance placed on the content. Where the content includes any translated material, BMJ does not warrant the accuracy and reliability of the translations (including but not limited to local regulations, clinical guidelines, terminology, drug names and drug dosages), and is not responsible for any error and/or omissions arising from translation and adaptation or otherwise.