{
  "abstract": "Background Chronic obstructive pulmonary disease (COPD) is an often-progressive respiratory disease associated with disabling breathlessness. Breathlessness intervention services (BIS), which coach patients to self-manage breathlessness using non-pharmacological strategies, are effective in a variety of populations, including those with cancer and serious respiratory disease. This study aimed to compare the impact of the Westmead Breathlessness Service in people with moderate to severe COPD.Methods We analysed 113 participants randomised (1:1) with moderate/severe COPD (forced expiratory volume in 1 s (FEV 1)/forced vital capacity <0.70 and FEV1 ≤60% predicted) and disabling breathlessness (modified Medical Research Council (mMRC) Breathlessness Score ≥2) to either an 8-week intervention involving breathing techniques, handheld fan use, exercise, energy conservation, dietetic advice (n=54) or 8-week wait-list control group (n=59). The primary outcome was change in Chronic Respiratory Questionnaire (CRQ) Mastery of breathlessness subscale. Secondary outcomes included change in other CRQ subscales (Fatigue, Emotion and Dyspnoea), exertional breathlessness intensity/unpleasantness (0–10 Numerical Rating Scale Score), anxiety and depression. Difference in change over 8 weeks between groups was compared using ANCOVA; p<0.05 statistically significant.Findings Participants were aged 70.9 (±8.5) years, 50% female, mean FEV 1 =0.8 L (±0.3 L; 34% predicted), mMRC Breathlessness Score 3 (IQR 3–4). CRQ-Mastery improved following intervention compared with control (between-group difference 0.5 units; 95% CI 0.2 to 0.8; p=0.0262) using modified intention-to-treat analysis. Better CRQ-Dyspnoea and CRQ-Fatigue were seen in the intervention group (between-group difference-CRQ-Dyspnoea 0.4 units; CI 0.1 to 0.7; p=0.005, and CRQ-Fatigue 0.4 units; CI 0.1 to 0.7; p=0.014). Exertional breathlessness intensity (difference −0.8 units; CI −1.4 to –0.2; p=0.013) and breathlessness unpleasantness (difference −1.2 units; CI −1.7 to –0.6; p=0.001) also improved.Interpretation An 8-week BIS improved CRQ-Mastery, Dyspnoea and Fatigue, exertional breathlessness intensity and unpleasantness in people with severe COPD.",
  "authors": [
    {
      "affiliations": [
        "Department of Respiratory and Sleep Medicine, Western Sydney Local Health District, Wentworthville, New South Wales, Australia",
        "Faculty of Medicine and Health, Sydney, New South Wales, Australia"
      ],
      "name": "Tracy A Smith"
    },
    {
      "affiliations": [
        "Department of Respiratory and Sleep Medicine, Western Sydney Local Health District, Wentworthville, New South Wales, Australia",
        "Faculty of Medicine and Health, Sydney, New South Wales, Australia",
        "Westmead Institute for Medical Research, Westmead, New South Wales, Australia",
        "Health, University of Technology Sydney, Sydney, New South Wales, Australia"
      ],
      "name": "Mary M Roberts"
    },
    {
      "affiliations": [
        "Health, University of Technology Sydney, Sydney, New South Wales, Australia"
      ],
      "name": "Tim Luckett"
    },
    {
      "affiliations": [
        "Department of Respiratory and Sleep Medicine, Western Sydney Local Health District, Wentworthville, New South Wales, Australia",
        "Faculty of Medicine and Health, Sydney, New South Wales, Australia",
        "Westmead Institute for Medical Research, Westmead, New South Wales, Australia"
      ],
      "name": "Jin-Gun Cho"
    },
    {
      "affiliations": [
        "Department of Respiratory and Sleep Medicine, Western Sydney Local Health District, Wentworthville, New South Wales, Australia"
      ],
      "name": "Ester Klimkeit"
    },
    {
      "affiliations": [
        "Department of Respiratory and Sleep Medicine, Western Sydney Local Health District, Wentworthville, New South Wales, Australia"
      ],
      "name": "Heather Stephenson"
    },
    {
      "affiliations": [
        "Institute for Health Transformation, School of Health and Social Development, Faculty of Health, Deakin University, Melbourne, Victoria, Australia"
      ],
      "name": "Nicola McCaffrey"
    },
    {
      "affiliations": [
        "NHMRC Clinical Trials Centre, Faculty of Medicine and Health, The University of Sydney, Sydney, New South Wales, Australia"
      ],
      "name": "Adrienne Kirby"
    },
    {
      "affiliations": [
        "Department of Respiratory and Sleep Medicine, Western Sydney Local Health District, Wentworthville, New South Wales, Australia",
        "Faculty of Medicine and Health, Sydney, New South Wales, Australia",
        "Westmead Institute for Medical Research, Westmead, New South Wales, Australia"
      ],
      "name": "John R Wheatley"
    }
  ],
  "title": "Multidisciplinary, non-pharmacological breathlessness intervention service for patients with moderately severe to severe COPD: a randomised controlled trial",
  "uid": "5e0228bf-06d7-598b-af95-e9b33c550e40"
}