Ann Schneidman

A scientific symposium today on “Palliative Management of Respiratory Symptoms” will address the effect of integrated palliative care, clinical importance and management of refractory dyspnea, and the concurrent symptoms of breathlessness, cough, and fatigue. The session will be held from 2:15 to 4:15 p.m. in Room 108/110/112 (Street Level) Colorado Convention Center.

Two palliative care experts are the symposium co-chairs: Ann Schneidman, MS, CNS, RN, CHPN, pulmonary resource program director at Hospice of the Valley in Phoenix, and Margaret Campbell, PhD, RN, research professor at Wayne State University in Detroit.

“The symposium will address the knowledge gap in the management of dyspnea and respiratory symptom clusters by presenting state-of-the-science palliative care research,” says Mrs. Schneidman, chair of the ATS Clinicians Advisory Committee. “Attendees will gain the evidence to support early palliative care and opioid therapy for refractory dyspnea in their patient populations.”

She pointed to three studies, the first calling for additional research focusing on the concepts of “total dyspnea” and the “dyspnea target,” clinical decision-making, barriers and facilitators to opioid therapy, and the minimal clinical intervention difference for acute and chronic dyspnea.

A second multi-center study explored the response patients with advanced lung disease and refractory dyspnea had to opioid therapy over four to six months.

“The findings support the safety and efficacy of careful initiation and titration of opioids based primarily on symptom severity. The transition from focusing on single symptoms occurred with the recognition that patients with cancer experience multiple concurrent symptoms,” Mrs. Schneidman says.

A third study examined clusters of symptoms in cancer patients during the 12 months after diagnosis.

“Shortness of breath and cough were identified as the respiratory symptom cluster,” Mrs. Schneidman adds. “There were significant differences in symptom frequency, severity, and distress in patients who had all the symptoms in the cluster as compared to the overall sample. Early palliative care is the unifying theme because it improves patient understanding of prognosis, quality of life, mood, and survival.”

The symposium’s goal is for attendees to be better able to advocate for integrated palliative care in patients newly diagnosed with lung cancer, identify the current state of science regarding symptom cluster patterns, and apply evidence-based practice in the management of refractory dyspnea.

Those who attend this symposium will also be interested in Wednesday’s symposium “The WELPICUS Study: Worldwide Consensus Around End of Life Principles for the Critically Ill” from 9:30 to 11:30 a.m. in Room 201/203 (Street Level) Colorado Convention Center.