Our research into breathlessness

Millions of people around the world live with breathlessness due to underlying conditions. It’s a problem that’s rarely recognised or even discussed, yet has a major impact on their lives.

Simply put, these people can’t catch their breath. And when the problem gets worse it can lead to a crisis situation. In fact, it may be responsible for as many as 20% of ambulance trips to the hospital.

But people who suffer from chronic breathlessness could often manage the problem at home if only they were given support. This would avoid a potentially difficult experience for patients and prevent a lot of wasted health service time and money for emergency departments.

Traditionally the management of patients with lung, heart and neuro-muscular diseases has focused only on the underlying disease – for example, the emphysema – without routinely looking at the impact that being out of breath over months and years has on patients’ everyday lives, or how that can be helped.

Here at Hull York Medical School in the Wolfson Palliative Care Research Centre, we are carrying out research into breathlessness to positively impact the lives of those living with the symptom. We hope to enable patients to share their concerns about their ongoing breathlessness with doctors and nurses and for clinicians to ask patients routinely, and to share self-help techniques which can help relieve breathlessness.

Our research

An exploratory systematic review and meta-analyses of airflow for the relief of chronic breathlessness in people with advanced disease
Many people live with continuing distress and difficulties arising from breathlessness despite treatment given to the underlying disease which causes it. This project addressed whether airflow provides relief of chronic breathlessness in people with advanced disease.

Breathlessness RElief AT HomE (BREATHE)
We want to see if we could run a research study that tests if paramedics trained in breathlessness techniques is more effective for people in breathlessness crisis than usual care in easing breathlessness and help more people stay at home.

Breathlessness is distressing for people with heart failure, and, as the condition worsens, may persist despite the best treatment. It’s already known breathlessness is safely improved by low-dose morphine in other conditions, such as cancer and chronic obstructive pulmonary disease. In this study, we tested if medium-term morphine therapy helps with breathlessness in heart failure patients.

Breathe Well: Improving the sustained use of supported self-management strategies for living well with chronic breathlessness
Chronic (persistent) breathlessness restricts social lives and day-to-day tasks. Breathlessness services can support people to self-manage, but there is often a gap between knowing what to do and doing it - true for patients, carers and clinicians alike. The aim of this study is to understand how to better enable supported self-management for people living with chronic breathlessness and to develop an implementation strategy to achieve this.

Bringing breathlessness into view
People living with breathlessness find their experience hard to describe to others. The aim of this project is to make an exhibition to show the public what it is like living with breathlessness.

Breathlessness and presentation to the emergency department: a survey and clinical record review
Breathlessness is a frequently occurring symptom of cardiorespiratory conditions and is a common cause of emergency department presentation. The aim of this study was to estimate the prevalence of acute-on-chronic breathlessness as a cause for presentation to the major emergencies area of the emergency department.

This project addresses the uncertainties relating to the design and conduct of a substantive phase 3 randomised controlled trial to evaluate a complex breathlessness intervention in patients with idiopathic pulmonary fibrosis (IPF) and chronic breathlessness.

Calming Hand and Fan Feasibility trial (CHAFF)
This study looks at two options to help relieve breathlessness: a hand-held battery operated fan designed to give cool airflow to the face, and the Calming Hand, a simple breathing strategy that could help reduce anxiety that often occurs with breathlessness.

ExacQual Study: Understanding people's experiences of exacerbations
Exacerbations of COPD are very distressing for patients and have long term consequences for their health. We want to explore patients and carers experiences, expectations and understanding of exacerbations and their help-seeking behaviour related to their exacerbations.

Living with breathlessness: systematic review and qualitative synthesis
Living with breathlessness can be very difficult, affecting every area of life. However, there are things that can do to make life easier. This project reviewed the large body of research on breathlessness to understand how patients' quality of life can be improved.

Morphine and Breathlessness (MABEL)
Chronic breathlessness is common and very disabling in people with heart and lung conditions and cancer. We want to see if 10 to 20mg per day of oral morphine is better than dummy capsules at improving breathlessness.