Projects

Here in the Wolfson Centre for Palliative Care Research, we strive to make a real and lasting improvements in the care which patients receive towards the end of their lives, and to the support provided to their families.

We believe that everybody has the right to the same, high-quality care, wherever and however they choose to be cared for. To this aim, our research projects follow the strategic objectives of the Wolfson Centre for Palliative Care.

Our projects

Addressing under-researched symptoms and problems

Breathlessness

BETTER-B: Trial of mirtazapine vs placebo (led by Kings College London)
Breathe Well: Improving the sustained use of supported self-management strategies for living well with chronic breathlessness
BREEZE: Feasibility study of a breathlessness complex intervention for people with interstitial lung disease
Bringing Breathlessness into View
Understanding people's experiences of exacerbations (the ExacQual Study) (AstraZeneca funded)
FANFARE–P: Fan Facial Airflow Recovery from Exercise Patient Trial. Implementation Acceleration Fund (Research England)
FanFIRST: Fan Feasibility Randomised Controlled Trial (RCT) for people living with COPD and high SABA intake
Fan implementation study (FITS): Clinician barriers/facilitators to implementation of the hand-held fan
Implementation of guideline-recommended asthma care (Astra-Zeneca)
Morphine and Breathlessness (MABEL)

Delirium

DAMPen-D study: Improving the Detection, Assessment, Management, and Prevention of Delirium in Specialist Palliative Care Units (SPCUs)

SUNRISE International consortium researching delirium in palliative care: The SUNRISE consortium (Studies to understand and improve delirium in palliative settings) includes researchers in the UK, Canada and Australia. Our research aims to improve the care of people with, and at risk of, delirium in palliative settings

Gastrointestinal

EPOC: Patient-centred decision making in malignant bowel obstruction to optimise survival and quality of life: the right treatment at the right time

Thrombosis

Serenity: Towards cancer patient empowerment for optimal use of antithrombotic therapy at the end of life: A realist review of how deprescribing interventions can improve shared decision-making for cancer patients in the last year of life

Reducing inequalities in palliative care outcomes, improving access and optimising delivery

Better End of Life: Collaboration with University of Cambridge and King’s College London
CANAssess2: Using the Needs Assessment Tool-Cancer (NAT-C) developed for use by doctors or other clinicians in GP surgeries to identify and address symptoms and unmet needs of cancer patients and their carers
C-POS: developing an assessment and outcome measure for paediatric palliative care – collaborative with King’s College London
Nat-ILD study: Completed study
Out of Hours models of community-based Palliative Care: Collaborative work with King’s College London
Palliative Care Interventions in Clinical Trials – A Systematic Review and Meta-Regression to Describe the Components of Care and explore their Relationship to Effectiveness
Proactive Anticipatory Care Evaluation (PACE): Study to assess the effectiveness of a proactive anticipatory multidisciplinary care intervention in improving the overall quality of life and health outcomes for severely frail older people
The role of ethnicity in opioid prescribing and health service use in the last three months of life: A population based comparative cohort study of cancer patients

Informing and improving palliative care services and outcomes in low and middle-income countries

BREATHE-INDIA: BREATHlEssness in INDIA: Development of a breathlessness beliefs and behaviour education intervention for use in the community-setting
Estimating worldwide needs for morphine for pain in advanced cancer and proportions theoretically met by country estimates of requirements and consumption
Exploring the association between chronic breathlessness and workforce participation, using Australia as an exemplar.
Improving Appropriate Access and Availability of Opioids for Cancer-related Pain Control in India: Bridging the gap between policy and practice – a qualitative study.
Roles and experiences of informal carers providing care to people with advanced cancer in Sub Saharan Africa

Spotlight on: Global Palliative Care

Access to palliative care, particularly in low and middle income countries, is one of the world's health largest inequalities. Here at the Wolfson Palliative Care Research Centre, we are developing collaborations and workstreams to address some of these issues. More about our research in global palliative care

Measuring individual and service-level palliative care outcomes

RESOLVE: Improving symptoms and well-being among those with advanced cancer across Yorkshire – collaborative work with University of Leeds
TRANSFORM: Palliative Care Outcomes Registry

Researching the social and psychological aspects of palliative care

This is a new and developing strategic objective, and project bids are in development, in particular work on how people with advanced illness experience diminishing social identity and connections in the months and weeks before death. Other projects in this area of work are already established.

Current projects:

SUPPORTED: a study of the role of homecare workers in supporting people living with advanced illness at home
Supporting families when a parent has died

Advancing education and research on implementation of palliative care evidence into policy and practice

Implementing asthma guidelines
Implementation training

Several projects (see above) have dedicated implementation components:

CANAssess2
Morphine and Breathlessness (MABEL)
RESOLVE: Improving symptoms and well-being among those with advanced cancer across Yorkshire – collaborative work with University of Leeds
Our delirium work
Fan implementation study

Other research

CanBenefit II: CANcer BEhavioural Nutrition and Exercise FeasibilIty Trial
CANFit: To compare a personalised home-based exercise programme with support from exercise professionals with NHS standard care
REMOTE-GO: Develop a personalised smartphone-based wellbeing programme for older adults living with and beyond cancer
Yorkshire and Humber Palliative Care Research Network: The Network aims to help address inequalities in palliative and end of life care across Yorkshire and Humber, for people of all ages.

Completed projects

Completed projects
Project	Publications and resources
A systematic review and critical interpretative synthesis of psychological concerns of Indian women with breast cancer living in different national contexts	BMJ
An exploratory systematic review and meta-analyses of airflow for the relief of chronic breathlessness in people with advanced disease	Palliative Medicine
Breathlessness RElief AT HomE (BREATHE)	ERJ Open Research
BreatheMOR-HF	ESC Heart Failure
Breathlessness and presentation to the emergency department: a survey and clinical record review	BMC Pulmonary Medicine
CANBenefit I	Journal of Cancer Survivorship Journal of Geriatric Oncology
Cancer patients’ experiences of living with venous thromboembolism: a systematic literature review	Palliative Medicine
C-CHANGE – developing and testing a case-mix classification in palliative care. An NIHR-funded project (RP-PG-1210-12015) led by Professor Fliss Murtagh at King’s College London, completed after moving to WPCRC	Annals of Palliative Medicine BMJ Palliative Medicine articles: Funding models in palliative care: Lessons from international experience How does uncertainty shape patient experience in advanced illness? A secondary analysis of qualitative data. Phase of illness in palliative care: Cross-sectional analysis of clinical data from community, hospital and hospice patients. A framework for complexity in palliative care: A qualitative study with patients, family carers and professionals. (Awarded Paper of the Month by Palliative Medicine) A Brief, Patient- and Proxy-Reported Outcome Measure in Advanced Illness: Validity, Reliability and Responsiveness of the Integrated Patient Outcome Scale (IPOS). Which outcome domains are important in palliative care and when? An international expert consensus workshop, using the nominal group technique. Establishing key criteria to define and compare models of specialist palliative care: A mixed-methods study using qualitative interviews and Delphi survey. Patients' views on care and their association with outcomes in palliative care.
CHAFF (Calming Hand and Fan Feasibility trial)	Journal of Pain and Symptom Management
CovPall	Palliative Medicine Journal of Pain and Symptom Management Palliative Medicine
Development of a core outcome set for delirium	Palliative Medicine
Does the International Narcotics Control Board (INCB) sufficiently prioritise enablement of access to therapeutic opioids?	Journal of Global Health Reports
HIDDen	The Lancet
How physicians in South India recognise, assess and manage people with chronic breathlessness syndrome	BMJ
Living with breathlessness: systematic review and qualitative syntheses.	European Respiratory Journal British Journal of General Practice Journal of Pain and Symptom Management
Modified ITT	Journal of Pain and Symptom Management
Missing data study	Journal of Clinical Epidemiology Journal of Clinical Epidemiology Missing data in trials: what you can do (jpeg)
NAT-ILD Study	NAT-ILD Study resources Thorax Thorax Journal of Palliative Medicine
Non-medical devices for the management of chronic breathlessness: A scoping review of device use, barriers and facilitators for patients, carers and clinicians
Palliative care in the emergency department: qualitative systematic literature review and thematic synthesis
Perceptions and experiences of laws and regulations governing access to opioids in South, Southeast, East and Central Asia
RAMBO: Development of a core outcome set for malignant bowel obstruction
Select-d experience study	Palliative Medicine
Using behaviour change theory to drive scalability of the hand-held fan for chronic breathlessness	BMC Pulmonary Medicine