Complex breathlessness intervention in idiopathic pulmonary fibrosis (BREEZE-IPF): a feasibility, wait-list design randomised controlled trial

Crooks, Michael George; Wright, Caroline; Hart, Simon; Allgar, Victoria; English, Anne; Swan, Flavia; Dyson, Judith; Richardson, Gerry; Twiddy, Maureen; Cohen, Judith; Simpson, Andrew; Huang, Chao; Sykes, Dominic L.; Johnson, Miriam

Abstract

Introduction Breathlessness is common and impairs the quality of life of people with idiopathic pulmonary fibrosis (IPF) and non-IPF fibrotic interstitial lung diseases (ILD). We report the findings of a multicentre, fast-track (wait-list), mixed-methods, randomised controlled, feasibility study of a complex breathlessness intervention in breathless IPF and non-IPF fibrotic ILD patients. Methods Breathless IPF and non-IPF fibrotic ILD patients were randomised to receive the intervention within 1 week (fast-track) or after 8 weeks (wait-list). The intervention comprised two face-to-face and one telephone appointment during a 3-week period covering breathing control, handheld fan-use, pacing and breathlessness management techniques, and techniques to manage anxiety. Feasibility and clinical outcomes were assessed to inform progression to, and optimal design for, a definitive trial. A qualitative substudy explored barriers and facilitators to trial and intervention delivery. Results 47 patients (M:F 38:9, mean (SD) age 73.9 (7.2)) were randomised with a recruitment rate of 2.5 participants per month across three sites. The adjusted mean differences (95% CI) for key clinical outcomes at 4 weeks post randomisation were as follows: Chronic Respiratory Questionnaire breathlessness mastery domain (0.45 (-0.07, 0.97)); and numerical rating scales for 'worst' (-0.93 (-1.95, 0.10)), 'best' (-0.19 (-1.38, 1.00)), 'distress caused by' (-1.84 (-3.29, -0.39)) and 'ability to cope with' (0.71 (-0.57, 1.99)) breathlessness within the past 24 hours. The qualitative substudy confirmed intervention acceptability and informed feasibility and acceptability of study outcome measures. Conclusion A definitive trial of a complex breathlessness intervention in patients with IPF and non-IPF fibrotic ILD is feasible with preliminary data supporting intervention effectiveness.

Citation

Crooks, M. G., Wright, C., Hart, S., Allgar, V., English, A., Swan, F., Dyson, J., Richardson, G., Twiddy, M., Cohen, J., Simpson, A., Huang, C., Sykes, D. L., & Johnson, M. (2025). Complex breathlessness intervention in idiopathic pulmonary fibrosis (BREEZE-IPF): a feasibility, wait-list design randomised controlled trial. BMJ Open Respiratory Research, 12(1), Article e002327. https://doi.org/10.1136/bmjresp-2024-002327

• Journal Article Type: Article
• Acceptance Date: Dec 5, 2024
• Online Publication Date: Mar 22, 2025
• Publication Date: Mar 22, 2025
• Deposit Date: Mar 25, 2025
• Publicly Available Date: Mar 27, 2025
• Journal: BMJ Open Respiratory Research
• Electronic ISSN: 2052-4439
• Publisher: BMJ Publishing Group
• Peer Reviewed: Peer Reviewed
• Volume: 12
• Issue: 1
• Article Number: e002327
• DOI: https://doi.org/10.1136/bmjresp-2024-002327
• Public URL: https://hull-repository.worktribe.com/output/5087885