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Respiratory problems in low-resource settings. | LitMetric

Respiratory problems in low-resource settings.

Curr Opin Support Palliat Care

aPalliative Care Unit, Makerere University, Kampala, Uganda; Cairdeas International Palliative Care Trust, Aberdeen, Scotland bAmrita Institute of Medical Sciences and Research Centre, Kochi, Kerala, India cNational Academy of Medical Sciences, Kathmandu, Nepal.

Published: September 2017

AI Article Synopsis

  • Chronic breathlessness is a common issue in advanced illness, especially in low and middle-income countries, where access to palliative care is limited compared to high-income countries.
  • The management of noncommunicable diseases (NCDs) in these settings faces challenges due to weak healthcare systems and a lack of multidisciplinary approaches.
  • Adaptations of evidence-based methods for breathlessness relief, such as using hand-held fans and low-dose morphine, are possible in low-income contexts, but further research is needed to effectively implement these strategies alongside promoting palliative care in NCD management.

Article Abstract

Purpose Of Review: Chronic breathlessness is common in patients with advanced illness who require palliative care. Achieving good symptom control can be challenging. More people with advanced illness live in low and middle income than in high-income countries, but they are much less likely to receive palliative care. Most of the emerging evidence for the palliative management of chronic breathlessness is from high-income countries. This review explores the context of chronic breathlessness in low-income settings, how evidence for control of chronic breathlessness might relate to these settings and where further work should be focused.

Recent Findings: Systems for control of noncommunicable diseases (NCDs) in these low-income contexts are poorly developed and health services are often overwhelmed with high levels both of NCD and communicable disease. Multidisciplinary and holistic approaches to disease management are often lacking in these settings. Developing an integrated primary care approach to NCD management is increasingly recognized as a key strategy and this should include palliative care. Most evidence-based approaches to the control of chronic breathlessness could be adapted for use in these contexts SUMMARY: Hand held fans, breathing techniques, graded exercise and use of low-dose morphine can all be used in low-income settings particularly in the context of holistic care. Research is needed into the most effective ways of implementing such interventions and palliative care needs to be promoted as a fundamental aspect of NCD management.

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Source
http://dx.doi.org/10.1097/SPC.0000000000000287DOI Listing

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