A mixed-methods pilot study of handheld fan for breathlessness in interstitial lung disease.

Abstract

Dyspnoea is a cardinal symptom of fibrotic interstitial lung disease (ILD), with a lack of proven effective therapies. With emerging evidence of the role of facial and nasal airflow for relieving breathlessness, this pilot study was conducted to examine the feasibility of conducting a clinical trial of a handheld fan (HHF) for dyspnoea management in patients with fibrotic ILD. In this mixed-methods, randomised, assessor-blinded, controlled trial, 30 participants with fibrotic ILD who were dyspnoeic with a modified Medical Research Council Dyspnoea grade ≥ 2 were randomised to a HHF for symptom control or no intervention for 2 weeks. Primary outcomes were trial feasibility, change in Dyspnoea-12 scores at Week 2, and participants' perspectives on using a HHF for dyspnoea management. Study recruitment was completed within nine months at a single site. Successful assessor blinding was achieved in the fan group [Bang's Blinding Index - 0.08 (95% CI - 0.45, 0.30)] but not the control group [0.47 (0.12, 0.81)]. There were no significant between-group differences for the change in Dyspnoea-12 or secondary efficacy outcomes. During qualitative interviews, participants reported that using the HHF relieved breathlessness and provided relaxation, despite initial scepticism about its therapeutic benefit. Oxygen-experienced participants described the HHF being easier to use, but not as effective for symptomatic relief, compared to oxygen therapy. Our results confirmed the feasibility of a clinical trial of a HHF in fibrotic ILD. There was a high level of patient acceptance of a HHF for managing dyspnoea, with patients reporting both symptomatic benefits and ease of use.

• Authors: Yet H Khor, Kirushallini Saravanan, Anne E Holland, Joanna Y T Lee, Christopher J Ryerson, Christine F McDonald, Nicole S L Goh
• Journal: Scientific reports (Sci Rep) Vol. 11 Issue 1 Pg. 6874 (03 25 2021) ISSN: 2045-2322 [Electronic] England
• PMID: 33767311 (Publication Type: Journal Article, Randomized Controlled Trial, Research Support, Non-U.S. Gov't)

Topics

• Aged
• Case-Control Studies
• Dyspnea (etiology, pathology, therapy)
• Female
• Humans
• Lung Diseases, Interstitial (complications)
• Male
• Oxygen Inhalation Therapy (instrumentation, methods)
• Pilot Projects
• Quality of Life
• Self-Management (methods)
• Single-Blind Method