Background Non-medical devices such as the handheld fan (fan), mobility aids (wheeled walkers with seats) and inspiratory muscle training (IMT) devices offer benefits for patient management of chronic breathlessness. We examined the published evidence regarding patient, carer and clinician use of the fan, mobility aids and IMT devices for chronic breathlessness management, and the potential barriers and facilitators to day-to-day use in a range of settings.
Methods MEDLINE, Embase, Scopus, EBSCO and the Cochrane Database of Systematic Reviews were searched. Papers were imported into EndNote and Rayyan for review against a priori eligibility criteria. Outcome data relevant to use were extracted and categorised as potential barriers and facilitators, and a narrative synthesis exploring reasons for similarities and differences conducted.
Results Seven studies met the inclusion criteria (n=5 fan, n=2 mobility aids and n=0 IMT devices). All of the studies presented patient use of non-medical devices only. Patients found the fan easy to use at home. Mobility aids were used mainly for outdoor activities. Outdoor use for both devices were associated with embarrassment. Key barriers included: appearance; credibility; self-stigma; technical specifications. Common facilitators were ease of use, clinical benefit and feeling safe with the device.
Conclusion The efforts of patients, carers and clinicians to adopt and use non-medical devices for the management of chronic breathlessness is impeded by lack of implementation research. Future research should improve knowledge of the barriers and facilitators to use. This would enhance understanding of how decision-making in patient–carer–clinician triads impacts on non-medical devices use for breathlessness management.
- chronic conditions
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Contributors FS and MP created the concept and design of the study. FS and ASP created the search strategies. ASP and GIL conducted the searches and screened records. ASP, GIL and FS extracted the data. FS and ASP interpreted and analysed the data. FS, ASP and MP prepared the manuscript. FS, ASP, GIL, MP, MJJ and TL edited and reviewed the final manuscript. FS is responsible for the overall content.
Funding This work was supported by the INSPIRE grant generously awarded to Hull York Medical School by the Academy of Medical Sciences through the Wellcome Trust (Ref: IR5\1018).
Competing interests None declared.
Provenance and peer review Not commissioned; externally peer reviewed.