The management of chronic breathlessness
Chronic breathlessness can be hard to make sense of and manage because its severity is often unrelated to the severity of the underlying medical conditions. Treatments for the underlying conditions may help breathlessness but rarely ameliorate it. This chapter will review the latest evidence for the nonpharmacological and pharmacological management of chronic breathlessness using a transdiagnostic approach. These approaches will be discussed using the Breathing, Thinking, Functioning framework, which conceptualises breathlessness in a way that helps understand the symptom and provides a rationale for symptom management. Although developed in a palliative breathlessness setting, the model can be used when a patient first presents with chronic breathlessness. Each element of this model can be addressed through different techniques such as breathing exercises and positioning, anxiety management, exercise rehabilitation and pharmacotherapy. To help clinicians provide holistic breathlessness management, a "breathlessness toolbox" and an outline of "very brief advice" for short consultations are provided.
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