Understanding persistent breathlessness: impact on patients and optimal approaches to symptomatic reduction - an overview.

INTRODUCTION: Persistent breathlessness (breathlessness persisting despite optimal treatment for the underlying condition and resulting in disability) is a prevalent syndrome associated with chronic and life-limiting conditions. Improving the clinical recognition and assessment of persistent breathlessness is essential to ensure people are provided with the best treatment for optimal symptom control. AREAS COVERED: This overview focuses on the impact of persistent breathlessness on patients, carers and the health system. It highlights the importance of identifying persistent breathlessness in clinical consultations, suggests steps to recognize this syndrome and discusses the evidence for non-pharmacological and pharmacological treatments in this context. Future research directions are also suggested. EXPERT OPINION: Persistent breathlessness is often invisible because 1) people may not engage with the health system and 2) both clinicians and patients are reluctant to discuss breathlessness in clinical consultations. Improving the recognition and assessment of this syndrome is critical to facilitate meaningful conversations between patients and clinicians and ensure patient-centered care. Non-pharmacological strategies are key to improving symptom management and health outcomes. Regular, low-dose, sustained-release morphine may help further reduce breathlessness in people who remain symptomatic despite disease-specific and non-pharmacological therapies.

Roles and practices of specialist lung cancer nurses: a scoping review protocol.

OBJECTIVE: The objective of this scoping review is to map the available literature on the role of specialist lung cancer nurses. INTRODUCTION: The international literature acknowledges the importance of specialist cancer nurses who provide supportive care to patients. Historically, however, there has been a lack of consistent evidence to inform development and implementation of the role. INCLUSION CRITERIA: This review will consider quantitative and qualitative studies of any design or methodology that report on role characteristics or behaviors, practices, or activities, or other aspects of specialist lung cancer nurses in the acute care setting. Systematic reviews, professional body reports, as well as unpublished or published studies and reports will also be considered for inclusion. Textual or opinion papers will be excluded. METHODS: This review will follow the JBI methodology for scoping reviews. Relevant papers from 2006 to 2022, in any language, will be searched for in the following databases and registries: MEDLINE (PubMed), CINAHL (EBSCO), Web of Science, Embase, and the Cochrane Register of Controlled Trials. Websites to be searched will include the World Health Organization, International Council of Nurses, and Agency for Healthcare Research and Quality. ProQuest Dissertations and Theses (ProQuest) and Grey Matters (CADTH) will be searched for unpublished literature. Results will be presented in tabular and narrative format and mapped according to the specified concepts of interest, as well as to the domains of practice for specialist nursing roles.

Development of an Australia and New Zealand Lung Cancer Clinical Quality Registry: a protocol paper.

INTRODUCTION: Lung cancer is the leading cause of cancer mortality, comprising the largest national cancer disease burden in Australia and New Zealand. Regional reports identify substantial evidence-practice gaps, unwarranted variation from best practice, and variation in processes and outcomes of care between treating centres. The Australia and New Zealand Lung Cancer Registry (ANZLCR) will be developed as a Clinical Quality Registry to monitor the safety, quality and effectiveness of lung cancer care in Australia and New Zealand. METHODS AND ANALYSIS: Patient participants will include all adults >18 years of age with a new diagnosis of non-small-cell lung cancer (NSCLC), SCLC, thymoma or mesothelioma. The ANZLCR will register confirmed diagnoses using opt-out consent. Data will address key patient, disease, management processes and outcomes reported as clinical quality indicators. Electronic data collection facilitated by local data collectors and local, state and federal data linkage will enhance completeness and accuracy. Data will be stored and maintained in a secure web-based data platform overseen by registry management. Central governance with binational representation from consumers, patients and carers, governance, administration, health department, health policy bodies, university research and healthcare workers will provide project oversight. ETHICS AND DISSEMINATION: The ANZLCR has received national ethics approval under the National Mutual Acceptance scheme. Data will be routinely reported to participating sites describing performance against measures of agreed best practice and nationally to stakeholders including federal, state and territory departments of health. Local, regional and (bi)national benchmarks, augmented with online dashboard indicator reporting will enable local targeting of quality improvement efforts.