Improving Breathlessness research programme

An integrated programme on breathlessness commenced in September 2004, primarily supported by Cicely Saunders International but with specific projects also receiving external funding.

The programme consists of several research projects on breathlessness in advanced and progressive disease and is led by Professor Irene J Higginson and Dr Claudia Bausewein

Several studies have been conducted within the programme:

• Dr Sara Booth implemented a Breathlessness Intervention Service (BIS) at Addenbrooke's NHS Trust, Cambridge. This service is currently being evaluated using the MRC Framework for the Evaluation of Complex Interventions by Dr Morag Farquhar who is based at Cambridge. Further information about the BIS is on the BSI section of the Addenbrooke's website
• Dr Marjolein Gysels has explored the experiences of breathlessness among patients with advanced disease with different conditions (lung cancer, COPD, cardiac failure, MND), at different stages of their illness and in different care settings.
• As part of her PhD, Dr Bausewein conducted a longitudinal study describing the course of breathlessness in advanced cancer and COPD and to explore over time and towards death. An RCT embedded in this study to test the effectiveness of a hand-held fan to reduce breathlessness was investigated simultaneously.
• For her PhD Dr Farida Malik conducted  a study to describe and contrast the experience of caring for a breathless patient with a diagnosis of heart failure or lung cancer. In particular, it describes the caregivers’ sleep patterns and sleep quality, level of burden and quality of life. It also explores what factors affect the caregiving experience.

 

Systematic reviews being conducted

• Measurement of breathlessness in advanced disease: a systematic review
• Experiences of breathlessness: a systematic review of the qualitative literature
• Non-pharmacological interventions in advanced stages of malignant and non-malignant diseases: a Cochrane Review
• Benzodiazepines for the relief of breathlessness in advanced malignant and non-malignant diseases in adults: a Cochrane Review
• Neuromuscular electrical stimulation for muscle weakness in adults with advanced disease: a Cochrane Review

Ongoing research studies

• Phase III RCT comparing the Breathlessness Intervention Service at Addenbrooke’s Hospital, Cambridge to standard care for patients with any diagnosis including an economic evaluation (Dr Booth)
• Experience of episodic breathlessness in patients with advanced disease (Dr Steffen Simon).
• Development, effectiveness and cost-effectiveness of a new out-patient breathlessness support service at King’s College Hospital (Prof Higginson, Prof Moxham, Dr Bausewein, Dr Jolley)
• Placebo controlled RCT of neuromuscular electrical stimulation of the thighs to improve exercise capacity in people with severe COPD (Dr Maddocks, Prof Higginson, Prof Polkey, Dr Hart, Dr Rafferty, Prof Moxham)

Planned research studies

The programme aims to evaluate further pharmacological and non-pharmacological interventions for the relief of breathlessness in advanced disease.

 

Collaborations

We aim to develop a database of relevant work and extend collaborations with others working in this field.