@article { , title = {A mixed-methods, randomized controlled, feasibility trial to inform the design of a phase 3 trial to test the effect of the hand-held fan on physical activity and carer anxiety in patients with refractory breathlessness}, abstract = {Context The handheld fan is an inexpensive and safe way to provide facial airflow, which may reduce the sensation of chronic refractory breathlessness, a frequently encountered symptom. Objectives To test the feasibility of developing an adequately powered, multicenter, multinational randomized controlled trial comparing the efficacy of a handheld fan and exercise advice with advice alone in increasing activity in people with chronic refractory breathlessness from a variety of medical conditions, measuring recruitment rates; data quality; and potential primary outcome measures. Methods This was a Phase II, multisite, international, parallel, nonblinded, mixed-methods randomized controlled trial. Participants were centrally randomized to fan or control. All received breathlessness self-management/exercise advice and were followed up weekly for four weeks. Participants/carers were invited to participate in a semistructured interview at the study's conclusion. Results Ninety-seven people were screened, 49 randomized (mean age 68 years; 49\% men), and 43 complet ed the study. Site recruitment varied from 0.25 to 3.3/month and screening:randomization from 1.1:1 to 8.5:1. There were few missing data except for the Chronic Obstructive Pulmonary Disease Self-Efficacy Scale (two-thirds of data missing). No harms were observed. Three interview themes included 1) a fan is a helpful self-management strategy, 2) a fan aids recovery, and 3) a symptom control trial was welcome. Conclusion A definitive, multisite trial to study the use of the handheld fan as part of self-management of chronic refractory breathlessness is feasible. Participants found the fan useful. However, the value of information for changing practice or policy is unlikely to justify the expense of such a trial, given perceived benefits, the minimal costs, and an absence of harms demonstrated in this study.}, doi = {10.1016/j.jpainsymman.2015.11.026}, eissn = {1873-6513}, issn = {0885-3924}, issue = {5}, journal = {Journal of pain and symptom management}, pages = {807-815}, publicationstatus = {Published}, publisher = {Elsevier}, url = {https://hull-repository.worktribe.com/output/383440}, volume = {51}, keyword = {Health and Health Inequalities, Refractory breathlessness}, year = {2016}, author = {Johnson, Miriam J. and Booth, Sara and Currow, David C. and Lam, Lawrence T. and Phillips, Jane L.} }