Aims: To determine prevalence and characteristics of dyspnoea-related distress in an Australian palliative care population with lung cancer.
Methods: Palliative Care Outcomes Collaboration (PCOC), a collective of palliative care centres across Australia, provided data, including:
Our primary outcome was proportion of cases reporting dyspnoea-related distress at first encounter with a service. Secondary outcomes were (i) associations between dyspnoea-related distress and other symptom distress, RUG-ADL and AKPS, and (ii) if demographic characteristics predicted dyspnoea-related distress.
Frequency analysis was used to determine our primary outcome. Generalised Estimated Equations (GEE) estimated odds ratios (OR) for dyspnoea accounting for longitudinal observations.
Results: The dataset comprised 240,171 clinical encounters, n=61,428 were complete first encounters. Of first encounters, n=37,811 (61.5%) experienced dyspnoea, of this mild dyspnoea was most prevalent (n=20,195; 45.6%), then moderate (n=13,745; 31%) and severe (n=3,871; 8.7%).
Dyspnoea was positively correlated with insomnia (r=.30), fatigue (r=.44), pain (r=.16), problems with psychological/spiritual wellbeing (r=.24), and other symptoms (r=.44).
Older patients, aged 50-65 and 65+ were more likely to report any dyspnoea than those younger (50-65 yrs: OR=1.17, 95% CI [1.12, 1.23]; 65+ yrs: OR=1.52, 95% CI [1.45, 1.59]. Non-English speakers were less likely to report dyspnoea OR=0.77, 95% CI [0.74, 0.79]. Patients located in large rural towns (OR=1.10, 95% CI [1.05, 1.15]) and remote/very remote communities (OR=1.13, 95% CI [1.08, 1.18]) were more likely to report dyspnoea.
Conclusions: Approximately two thirds of LC patients who enter palliative care services in Australia report experiencing dyspnoea-related distress, with almost 40% reporting moderate/severe levels. Dyspnoea appears to cluster with other symptoms. Older patients, English speakers, and some regional/remote communities are more likely to report dyspnoea-related distress.