About the project

Title: FanFIRST: Fan Feasibility Randomised Controlled Trial (RCT) for people living with COPD and high SABA intake 
Funder: NIHR Research for Patient Benefit
Time frame: 2023-2025
Contact for more details: Professor Michael Crooks (Clinical Sciences Centre)

Breathlessness is the most common symptom in chronic obstructive pulmonary disease (COPD) which greatly impairs quality of life. COPD is mainly treated using inhalers taken once-or-twice every day, but another type of inhaler, called a short-acting beta agonist (SABA), is only meant to be used when needed to provide short-term symptom relief.

People with COPD often don’t know how best to manage their breathlessness and can become reliant on their SABA, using it too often, risking side effects. Those with COPD that use their SABA frequently have worse breathlessness and are more likely to have COPD ‘flare-ups’.

We believe that teaching COPD patients how to use a hand-held-fan, and other techniques to manage their breathlessness (the FanFIRST intervention), may improve their breathlessness and reduce how often they need their SABA. SABA inhalers contain a strong greenhouse gas that contributes to global warming. Therefore, reducing how many SABA inhalers are used each year has potential dual-benefits to both COPD patients and the environment.

We will invite 80 people with COPD that use their SABA inhaler frequently. Eligible participants will be chosen at random to receive either the FanFIRST intervention, or usual care. Regardless of study condition, all participants will be given devices that attach to their SABA inhaler to count how often they are used. We will measure usage throughout the study and compare use at the start of the study with usage at the end of the study. People will take part for 4 months in total, with breathlessness questionnaires and other measures completed every 28 days during the study. A total of 40 participants (and their carers) will also be invited to take part in an interview with a researcher.

The results of the feasibility study will tell us two important things. First, whether a larger trial is possible, and if so, how best to run it. Second, if provisional results are deemed effective, how best to roll-out the FanFIRST intervention across the NHS.