Fan-on-Face Therapy in Relieving Dyspnea of Adult Terminally Ill Cancer Patients: A Meta-Analysis

Abstract

<jats:title>Abstract</jats:title><jats:p> Introduction Dyspnea is often encountered in terminally ill cancer patients and is attributed to multiple factors. The use of fan-on-face therapy is a nonpharmacologic adjunct treatment for adult cancer patients suffering from dyspnea at the end-of-life. This study was done to determine if the use of fan-on-face therapy in addition to the standard of care treatment indeed confers clinical benefit to terminally ill adult cancer patients with dyspnea.</jats:p><jats:p> Materials and Methods A meta-analysis of randomized controlled trials on the use of fan-on-face therapy in relieving dyspnea among terminally ill adult cancer patients was performed. A computerized search was done in MEDLINE, NICE, CENTRAL, Science Direct, and Google Scholar for relevant articles. Other publications were searched, and authors were contacted for additional information. The primary outcome measure was the mean change in dyspnea score, determined by the Modified Borg Scale, Numeric Rating Scale, or Visual Analog Scale. The secondary outcome was the post-intervention mean change in respiratory rate (RR).</jats:p><jats:p> Results Four eligible randomized controlled trials of low to moderate risk of bias employed a total of 139 cancer patients. Fan-on-face therapy was effective in decreasing mean dyspnea scores (standard mean difference = −1.81, 95% confidence interval [CI]: −3.12, −0.50, p &lt; 0.00001, I 2 93%) and improving mean change in RR (mean difference = −0.91, 95% CI: −1.68, −0.15; p = 0.001, I 2 = 81%) versus control.</jats:p><jats:p> Conclusion Fan-on-face therapy, as an adjunct to standard of care, is effective in alleviating dyspnea among adult cancer patients during the end of life.</jats:p>

Implementing the battery-operated hand-held fan as an evidence-based, non-pharmacological intervention for chronic breathlessness in patients with chronic obstructive pulmonary disease (COPD): a qualitative study of the views of specialist respiratory clinicians

“…One such intervention is the battery-operated hand-held fan (‘fan’). Four meta-analyses, conducted across chronic diseases [ 3 , 4 ] and in advanced cancer more specifically [ 5 , 6 ], have suggested that the fan decreases breathlessness intensity. In a pooled analysis of two trials, it was also found that more than half of patients reported an increase in physical activity [ 7 ].…”

Nursing support for symptoms in patients with cancer and caregiver burdens: a scoping review protocol

“…For example, fan therapy for dyspnoea has been introduced as a safe, inexpensive and effective method of support, owing to evidence accumulated in recent years, [13][14][15][16][17][18][19][20][21][22] and many systematic reviews and meta-analyses have explored this topic. [23][24][25][26][27][28] However, few nursing supports have been introduced in clinical guidelines.…”

“…Conversely, clinical guidelines reported by European Society for Medical Oncology Open in 202011 and the Journal of Clinical Oncology in 202112 stated that non-pharmacological approaches, including nursing support, are the first-line treatment option in the management of dyspnoea, complementing the support provided by pharmacological interventions. For example, fan therapy for dyspnoea has been introduced as a safe, inexpensive and effective method of support, owing to evidence accumulated in recent years,13–22 and many systematic reviews and meta-analyses have explored this topic 23–28. However, few nursing supports have been introduced in clinical guidelines.…”

The handheld fan for chronic breathlessness: Clinicians’ experiences and views of implementation in clinical practice

“…Evidence supports airflow from a fan as an effective non-pharmacological intervention for relief of this debilitating symptom in cancer and chronic respiratory conditions [12][13][14][15].…”