Non-Pharmacological Breathlessness Management in Older Patients: A Review Study

Background: Breathlessness is a multifactorial problem caused by multiple pathways and thus lends itself to a range of interventions, each targeting a specific mechanism. For a start, the aging process affects respiratory function and decreases lung elasticity and respiratory muscle strength, which results in forced vital capacity reduction. Moreover, many conditions, such as chronic obstructive pulmonary disease, can cause breathlessness. There is no single intervention to relieve breathlessness, particularly when we are dealing with chronic refractory breathlessness. This study aimed at conducting a review of studies on non-pharmacological breathlessness management in older patients. Methods: This review study used the (Preferred Reporting Items for Systematic Reviews and Meta-analyses) PRISMA protocol to select appropriate resources. Two journal databases of CINAHL and MEDLINE were searched in this regard. The inclusion criteria were as follows: original articles available in full-text, peer-reviewed articles written in English from 2008 to 2018, articles focus on non-pharmacological interventions with samples of the older people or patients (≥65 years old) complaining of dyspnea or breathlessness. Results: There were five articles which met all the above criteria. They used non-pharmacological treatments of (Transcutaneous Electrical Nerve Simulation on acupoints) Acu-TENS, cognitive behavior therapy, inspiratory muscle training, and yoga. Most of these interventions had been applied in older patients with chronic obstructive pulmonary disease (COPD), and then patients with thoracic malignancy and lung cancer in that order.  Conclusion: Based on the results, these non-pharmacological treatments show potential benefits in improving breathlessness for older patients. However, issues such ::::::as char::::::acteristic of the sample, including co-morbidities and smoking history, and the size of the sample should be considered.