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To What Extent Do the NRS and CRQ Capture Change in Patients' Experience of Breathlessness in Advanced Disease? Findings From a Mixed-Methods Double-Blind Randomized Feasibility Trial

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To What Extent Do the NRS and CRQ Capture Change in Patients' Experience of Breathlessness in Advanced Disease? Findings From a Mixed-Methods Double-Blind Randomized Feasibility Trial. / Lovell, Natasha; Etkind, Simon Noah; Bajwah, Sabrina; Maddocks, Matthew; Higginson, Irene Julie.

In: Journal of pain and symptom management, Vol. 58, No. 3, 01.09.2019, p. 369-381.e7.

Research output: Contribution to journalArticle

Harvard

Lovell, N, Etkind, SN, Bajwah, S, Maddocks, M & Higginson, IJ 2019, 'To What Extent Do the NRS and CRQ Capture Change in Patients' Experience of Breathlessness in Advanced Disease? Findings From a Mixed-Methods Double-Blind Randomized Feasibility Trial', Journal of pain and symptom management, vol. 58, no. 3, pp. 369-381.e7. https://doi.org/10.1016/j.jpainsymman.2019.06.004

APA

Lovell, N., Etkind, S. N., Bajwah, S., Maddocks, M., & Higginson, I. J. (2019). To What Extent Do the NRS and CRQ Capture Change in Patients' Experience of Breathlessness in Advanced Disease? Findings From a Mixed-Methods Double-Blind Randomized Feasibility Trial. Journal of pain and symptom management, 58(3), 369-381.e7. https://doi.org/10.1016/j.jpainsymman.2019.06.004

Vancouver

Lovell N, Etkind SN, Bajwah S, Maddocks M, Higginson IJ. To What Extent Do the NRS and CRQ Capture Change in Patients' Experience of Breathlessness in Advanced Disease? Findings From a Mixed-Methods Double-Blind Randomized Feasibility Trial. Journal of pain and symptom management. 2019 Sep 1;58(3):369-381.e7. https://doi.org/10.1016/j.jpainsymman.2019.06.004

Author

Lovell, Natasha ; Etkind, Simon Noah ; Bajwah, Sabrina ; Maddocks, Matthew ; Higginson, Irene Julie. / To What Extent Do the NRS and CRQ Capture Change in Patients' Experience of Breathlessness in Advanced Disease? Findings From a Mixed-Methods Double-Blind Randomized Feasibility Trial. In: Journal of pain and symptom management. 2019 ; Vol. 58, No. 3. pp. 369-381.e7.

Bibtex Download

@article{e3343a493cf2481ab688d70c33887c35,
title = "To What Extent Do the NRS and CRQ Capture Change in Patients' Experience of Breathlessness in Advanced Disease? Findings From a Mixed-Methods Double-Blind Randomized Feasibility Trial",
abstract = "Context: Chronic or refractory breathlessness is common and distressing. To evaluate new treatments, outcome measures that capture change in patients' experience are needed. Objectives: To explore the extent to which the numerical rating scale (NRS) worst and average, and the Chronic Respiratory Questionnaire capture change in patients' experience during a trial of mirtazapine for refractory breathlessness. Methods: Convergent mixed-methods design embedded within a randomized trial comprising 1) semi-structured qualitative interviews (considered to be the gold standard) and 2) outcome measure data collected pre- and post-intervention. Data were integrated, exploring examples where findings agreed and disagreed. Adults with advanced cancer, chronic obstructive pulmonary disease, interstitial lung disease, or chronic heart failure, with a modified Medical Research Council dyspnea scale grade 3 or 4 were recruited from three U.K. sites. Results: Data were collected for 22 participants. Eleven had a diagnosis of chronic obstructive pulmonary disease, eight interstitial lung disease, two chronic heart failure, and one cancer. Median age was 71 (56–84) years. Sixteen participants were men. Changes in the qualitative data were commonly captured in the NRS (worst and average) and the Chronic Respiratory Questionnaire. The NRS worst captured change most frequently. Improvement in the emotional domain was associated with physical changes, improved confidence, and control. Conclusion: This study found that the NRS using the question “How bad has your breathlessness felt at its worst over the past 24 hours?” captured change across multiple domains, and therefore may be an appropriate primary outcome measure in trials in this population. Future work should confirm the construct validity of this question.",
keywords = "advanced disease, Breathlessness, outcome measure, randomized controlled trial, shortness of breath",
author = "Natasha Lovell and Etkind, {Simon Noah} and Sabrina Bajwah and Matthew Maddocks and Higginson, {Irene Julie}",
year = "2019",
month = "9",
day = "1",
doi = "10.1016/j.jpainsymman.2019.06.004",
language = "English",
volume = "58",
pages = "369--381.e7",
journal = "Journal of pain and symptom management",
issn = "0885-3924",
number = "3",

}

RIS (suitable for import to EndNote) Download

TY - JOUR

T1 - To What Extent Do the NRS and CRQ Capture Change in Patients' Experience of Breathlessness in Advanced Disease? Findings From a Mixed-Methods Double-Blind Randomized Feasibility Trial

AU - Lovell, Natasha

AU - Etkind, Simon Noah

AU - Bajwah, Sabrina

AU - Maddocks, Matthew

AU - Higginson, Irene Julie

PY - 2019/9/1

Y1 - 2019/9/1

N2 - Context: Chronic or refractory breathlessness is common and distressing. To evaluate new treatments, outcome measures that capture change in patients' experience are needed. Objectives: To explore the extent to which the numerical rating scale (NRS) worst and average, and the Chronic Respiratory Questionnaire capture change in patients' experience during a trial of mirtazapine for refractory breathlessness. Methods: Convergent mixed-methods design embedded within a randomized trial comprising 1) semi-structured qualitative interviews (considered to be the gold standard) and 2) outcome measure data collected pre- and post-intervention. Data were integrated, exploring examples where findings agreed and disagreed. Adults with advanced cancer, chronic obstructive pulmonary disease, interstitial lung disease, or chronic heart failure, with a modified Medical Research Council dyspnea scale grade 3 or 4 were recruited from three U.K. sites. Results: Data were collected for 22 participants. Eleven had a diagnosis of chronic obstructive pulmonary disease, eight interstitial lung disease, two chronic heart failure, and one cancer. Median age was 71 (56–84) years. Sixteen participants were men. Changes in the qualitative data were commonly captured in the NRS (worst and average) and the Chronic Respiratory Questionnaire. The NRS worst captured change most frequently. Improvement in the emotional domain was associated with physical changes, improved confidence, and control. Conclusion: This study found that the NRS using the question “How bad has your breathlessness felt at its worst over the past 24 hours?” captured change across multiple domains, and therefore may be an appropriate primary outcome measure in trials in this population. Future work should confirm the construct validity of this question.

AB - Context: Chronic or refractory breathlessness is common and distressing. To evaluate new treatments, outcome measures that capture change in patients' experience are needed. Objectives: To explore the extent to which the numerical rating scale (NRS) worst and average, and the Chronic Respiratory Questionnaire capture change in patients' experience during a trial of mirtazapine for refractory breathlessness. Methods: Convergent mixed-methods design embedded within a randomized trial comprising 1) semi-structured qualitative interviews (considered to be the gold standard) and 2) outcome measure data collected pre- and post-intervention. Data were integrated, exploring examples where findings agreed and disagreed. Adults with advanced cancer, chronic obstructive pulmonary disease, interstitial lung disease, or chronic heart failure, with a modified Medical Research Council dyspnea scale grade 3 or 4 were recruited from three U.K. sites. Results: Data were collected for 22 participants. Eleven had a diagnosis of chronic obstructive pulmonary disease, eight interstitial lung disease, two chronic heart failure, and one cancer. Median age was 71 (56–84) years. Sixteen participants were men. Changes in the qualitative data were commonly captured in the NRS (worst and average) and the Chronic Respiratory Questionnaire. The NRS worst captured change most frequently. Improvement in the emotional domain was associated with physical changes, improved confidence, and control. Conclusion: This study found that the NRS using the question “How bad has your breathlessness felt at its worst over the past 24 hours?” captured change across multiple domains, and therefore may be an appropriate primary outcome measure in trials in this population. Future work should confirm the construct validity of this question.

KW - advanced disease

KW - Breathlessness

KW - outcome measure

KW - randomized controlled trial

KW - shortness of breath

UR - http://www.scopus.com/inward/record.url?scp=85068414524&partnerID=8YFLogxK

U2 - 10.1016/j.jpainsymman.2019.06.004

DO - 10.1016/j.jpainsymman.2019.06.004

M3 - Article

C2 - 31201877

AN - SCOPUS:85068414524

VL - 58

SP - 369-381.e7

JO - Journal of pain and symptom management

JF - Journal of pain and symptom management

SN - 0885-3924

IS - 3

ER -

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