Skip to content

THIS IS A TEST!!!

A GP and patient in discussion

BREEZE

A randomised controlled trial of a complex intervention to manage breathlessness in pulmonary fibrosis

LEAD RESEARCHERS

Ann Hutchinson

Dr Ann Hutchinson

Research Fellow

Michael Crooks

Professor Michael Crooks

Professor of Respiratory Medicine

TIME FRAME

2024 - 2026

FUNDED BY

COLLABORATORS

Why our research is needed

Diseases which cause scarring of the lungs (called pulmonary fibrosis) usually affect older adults.

They progress over time, causing regular coughing and making it hard to breathe. There are medications that slow disease progress, however they do not improve symptoms nor quality of life.

Shortness of breath is the most common symptom and the one which has the biggest impact on the lives of those affected. Breathlessness treatments work for people with other lung conditions, but we do not know whether they work for people with lung scarring.

It is important that we find out how to help people affected, doctors and policy makers make correct treatment decisions. To be able to know if breathlessness management helps people with pulmonary fibrosis we first needed to find out the best way to design a full trial, so we carried out the BREEZE feasibility study.

We wanted to understand how many patients will be suitable and willing to take part in a trial of a breathlessness treatment, how many would complete the study tests and which measurements are most meaningful.

Forty-seven breathless patients with pulmonary fibrosis were randomly selected to receive the breathlessness treatment straight away or to wait eight weeks before starting the treatment.

The treatment involved training in techniques to help breathlessness and was delivered during two appointments and a telephone call over three weeks. Breathlessness and quality of life assessments and daily activity measurements were performed at the start of the study and repeated every four weeks for 16 weeks.

The pre-agreed criteria to decide if it is possible to do a larger trial to test the breathlessness treatments effectiveness were all met. This means that the overall design of the study can remain the same with only minor changes to ensure the success of the full trial.

Although the BREEZE study was not designed to test the treatment’s effectiveness, patients that received the treatment straight away appeared to improve across a range of breathlessness measures compared with those waiting for the treatment. This strongly supports the need for a larger trial.

Patients and the public have been involved in this research from the beginning. Members of the Hull pulmonary fibrosis support group consider this is an important area of research, as do Action for Pulmonary Fibrosis and Asthma and Lung UK.

We are now organising a full trial, called BREEZE 2, to find out if the breathlessness treatment works for people with pulmonary fibrosis and if it is affordable to the NHS.

Siemens

Our approach to patient and carer involvement

We are committed to involving patients, carers, families and local communities as active partners in shaping our research. We want to make sure that people with many different perspectives and experiences have the chance to influence what we do and how we do it. This helps us to focus on what really matters to people.

We have set up a Patient and Carer Advisory Group made up of 7 people from across the UK who have personal experience of living with pulmonary fibrosis. This includes people from Northern Ireland, Yorkshire, and the South West, who we recruited through NHS hospitals with specialist pulmonary fibrosis services. Some members of the group have lived with the condition for many years, and others were more recently diagnosed. Two members of the group are carers.

The group will meet online at regular points throughout the trial. Since the trial began the group has helped us to choose a logo for the trial and agreed the use of the term ‘carer’ to describe those who care for or support someone with pulmonary fibrosis. Before submitting our application for ethical approval, the group reviewed the information for people who will take part in the trial and in the interviews, to make sure it was clearly written and well designed. Their input helped us to improve how we described the two groups taking part in the trial, and the process that each would go through. We also added a question to help us capture if any trial participants have previously received breathlessness management support, outside of this trial.

As the trial progresses, we will share our findings with the group for sense checking, and they will then advise on ways of sharing our findings with trial participants, patients and the wider public. This will include making a film or animation, and a podcast, with members of the group.

We have also recruited two people with pulmonary fibrosis to sit on the Trial Steering Committee.

Carer Advisory Group member spotlight

My name is Mike Chorlton. I am 64 years old and live in Portishead, near Bristol. I was diagnosed with Idiopathic Pulmonary Fibrosis in Autumn 2021, although the disease had been with me for at least 2 years prior to that. I had no idea at all that I was ill. In September 2021, I got Covid and that developed into pneumonia. The pneumonia rapidly exacerbated the IPF. Within a month I went from swimming a mile before work every morning to being unable to climb my own flight of stairs without getting out of breath. This caused very significant scarring to my lungs. I was put on ambulatory oxygen and then on the list for a lung transplant.

When I was asked to join this advisory group, I felt happy to help if it would make the journey easier for people who follow me. However, it was with the understanding that, by the end of this trial, I would no longer have IPF. If I did not receive a transplant, I expected to die. I am delighted to say that, after 3 failed attempts at surgery, I received a beautiful pair of donor’s lungs in July 2024. I now have a future that was rapidly slipping away. Although I no longer have IPF, I have a very clear understanding of dealing with breathlessness, of trying to live a positive life with a terminal illness, of constantly waiting for a call to surgery, and of the impact that has on carers and other loved ones. I hope my experiences will help this group to develop the right, balanced perspectives.

Involve Hull

Discover more about getting involved in health and care research at the University of Hull through our public involvement network, Involve Hull

INVOLVE Hull
Siemens

Outputs

Wright C, Hart SP, Allgar V, et al. A feasibility, randomised controlled trial of a complex breathlessness intervention in idiopathic pulmonary fibrosis (BREEZE-IPF): study protocol. ERJ Open Res 2019; 5: 00186-2019

Funding

This project is funded by the National Institute for Health and Care Research (NIHR) under its Research for Patient Benefit (RfPB) Programme (Grant Reference Number NIHR206252). The views expressed are those of the author(s) and not necessarily those of the NIHR or the Department of Health and Social Care.

Contact us

We welcome enquiries about our research, or if you are interested in collaborating, visiting or postgraduate study with us.

Explore our research

Discover our world-leading palliative care research and find out how we are working to enhance the quality of life for individuals facing advanced illnesses.

More research projects