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.
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.
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.
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 addresses the large body of research on breathlessness to understand how patients' quality of life can be improved.
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 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.
CHAFF (Calming Hand and Fan Feasibility trial)
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.
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.
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.
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.
Select-d experience study
Cancer patients have a greater risk of venous thromboembolism than the general population. It is the commonest cause of death during chemotherapy. In this study, we explored patients and carers experience of cancer-associated thrombosis and its treatment.
Treatment for deep vein thrombosis (DVT) is recommended for all patients with advanced cancer in hospitals, yet it is not routine practice for those in specialist palliative care units, such as hospices. The aim of this study was to determine how many cancer patients admitted to hospices have DVTs and whether these cause problems and will result in a better understanding of how we should treat people with advanced cancer.
Cancer patients’ experiences of living with venous thromboembolism : a systematic literature review
People with cancer have a high risk of developing blood clots in their veins. These clots are treated by blood thinner drugs (either injections or tablets). This project summarises published research about people's experience of living with cancer and blood clots and points out the shortage of information about this serious and potentially preventable issue.
The purpose of this project is to develop a set of patient and researcher relevant core outcome measures through which clinical trials can evaluate various treatments for malignant bowel obstruction (MBO).
Improving the detection, assessment, management, and prevention of delirium in Specialist Palliative Care Units
This study will address the guideline implementation challenge of how to bring together practical support (e.g. screening tools and clinical pathways) and communication between family, friends, volunteers, and health professionals in a combined intervention-implementation strategy.
Delirium screening in hospices
The purpose of this study was to find out about how hospice staff identify delirium in hospices across the UK.
Does the International Narcotics Control Board (INCB) sufficiently prioritise enablement of access to therapeutic opioids? A systematic critical analysis of six INCB annual reports, 1968-2018
The INCB has overseen international drug control since 1968 with the dual remit of restricting illicit production and use of controlled substances, whilst enabling access for clinical purposes. The purpose of this project to explore the balance of restriction versus enabling access of opioids overseen by the International Narcotics Control Board (INCB).
Perceptions and experiences of laws and regulations governing access to opioids in South, Southeast, East and Central Asia: a systematic review, critical interpretative synthesis and development of a conceptual framework.
Opioids are essential pain-killing medicines. Despite international and national laws permitting availability, opioid access remains inadequate.
We conducted a systematic review of post-2000 research to explore the perceptions and experiences of regulatory enablers and barriers to opioid access in South, Southeast, East and Central Asia.
How physicians in South India recognise, assess and manage people with chronic breathlessness syndrome: a thematic analysis.
The purpose of this project is to explore the views of hospital physicians regarding chronic breathlessness syndrome, its recognition and management.
A systematic review and critical interpretative synthesis of the psychological concerns of Indian women with breast cancer living in different national contexts: the importance of culturally congruent care
Breast cancer is becoming the most common cancer among women of Indian origin. Little is known about the psychological impact of the disease and its treatment among this population.
The purpose of this research is to improve understanding of psychological symptoms of Indian women with breast cancer.
TRANSFORMing Cancer Outcomes in Yorkshire
The research, a £4.9m programme funded by Yorkshire Cancer Research, will help to understand why differences exist in cancer diagnosis and survival in Hull and Yorkshire, and how to reduce inequalities, speed up referrals, and improve access to care and treatment. The research will primarily focus on early diagnosis and detection of cancer, patient management and survivorship and palliative care. This project brings together researchers from Wolfson Palliative Care Research Centre, the Academy of Primary Care and the Cancer Research Group.
Here in the Wolfson Palliative Care Research Centre, we aim to help patients who have fibrosis of the lungs. We have developed a needs-assessment tool aimed to help doctors, nurses and respiratory/lung clinics to ask patients and carers about how their conditions are affecting their quality and life, to ensure their needs are dealt with effectively.
People with cancer need good access to palliative care, but we understand that not everyone gets the same access to these services. This can affect how well people cope with the cancer, and affect their quality of life. In this study, we are testing whether a large trial is feasible to see if the routine use of an assessment tool in cancer during routine practice makes a difference to patients.
This study will be carried out across Yorkshire and the North East of England. It will test if routine use of the Needs Assessment Tool-Cancer (NAT-C) improves’ patients and their carers’ experience compared with usual care. If the tool proves to be effective in reducing unresolved patient/carer problems, it will set a new standard of care across the whole of the UK, improving the experience of people with cancer and their families.
Palliative care in the emergency department: qualitative systematic literature review and thematic synthesis
Palliative care is a much-needed purpose of the emergency department, in addition to its role in treating acute conditions. In this research, we aim to raise awareness of the experience of patients, famililes and carers so that they get they help they need.
Does the International Control Board successfully balance its dual role as an enabler of access to medicine and a restrictor of illicit drug use: A discourse analysis of the annual reports of the INCB
The purpose of this project is to explore the discourse of the International Narcotics Control Board relating to enablement or restriction of narcotics, opiates, analgesia and opioids viewed through the lens of its annual reports 1968-2017.
Access to opioid medication for cancer pain management in Asia: A systematic review of barriers and facilitators
Cancer patients in Asia have very limited access to necessary pain medicines for a number of complex reasons. This project investigates the published literature regarding the practical challenges for cancer patients in accessing pain medicines in Asian countries.
Older people with cancer may not be fit enough to cope with some of the cancer treatments. There is some evidence to suggest that attention to exercise and diet may help people maintain their independence for longer and tolerate treatments better.
The aim of this study is to develop and model a complex nutrition and exercise intervention for older patients with lung cancer.
NIHR-funded project (RP-PG-1210-12015) led by Prof Fliss Murtagh at King’s College London.
Proactive Anticipatory Care Evaluation (PACE) project
In a new and unique approach to health and care for older people, an innovative new facility – the Integrated Care Centre - opened in Hull in 2018. The first of its type in the UK, it’s set to transform care for older people. This study will evaluate this new service.
Missing data study
Missing data has a huge impact on research, reducing the reliability of research findings. Here in the Wolfson Centre for Palliative Care, we are addressing why this happens and making recommendations how to to reduce research waste due to missing data.
Clinical trials in palliative care are hard to conduct, and patient data is particularly precious - provided by patients who are unwell. It is important we find the best methods to analyse clinical trial participants under these circumstances.
The purpose of this project is to explore the effect of a modified intention-to-treat (ITT) analysis on the power and effect size of clinical trials in palliative care.