A mixed-methods pilot study of domiciliary nasal high-flow therapy for breathlessness in people with chronic obstructive pulmonary disease who do not qualify for domiciliary long-term oxygen therapy.
| Title: | A mixed-methods pilot study of domiciliary nasal high-flow therapy for breathlessness in people with chronic obstructive pulmonary disease who do not qualify for domiciliary long-term oxygen therapy. |
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| Authors: | Smallwood, Natasha, Pascoe, Amy, Buchan, Catherine, Wong, Aaron K., Currow, David, Le, Brian |
| Source: | Therapeutic Advances in Respiratory Disease; 3/12/2025, p1-15, 15p |
| Subject Terms: | CHRONIC obstructive pulmonary disease, OXYGEN therapy, AIR flow, MEDICAL research, PHYSICAL mobility |
| Abstract: | Background: High-flow nasal oxygen (HFNO) therapy delivers humidified, heated air with flow rates of up to 60 L/min with oxygen entrained. HFNO has advantages over conventional oxygen therapy, including precise and reliable fraction of inspired oxygen delivery, therefore is recommended as first-line treatment for people with acute hypoxaemic respiratory failure. Objectives: This pilot study aimed to determine the feasibility and acceptability of domiciliary nasal high flow (NHF) without entrained oxygen for people with chronic obstructive pulmonary disease (COPD) and severe breathlessness. Design: Single-arm, mixed-methods, pilot study of an 8-day, air-only NHF intervention in adults with COPD and severe breathlessness not requiring domiciliary oxygen therapy. Methods: Participants were educated and advised to use NHF for ⩾7 h per night for 7 nights with day use as desired. Patient-reported outcome measures were assessed on Days 3, 5 and 8. Primary outcome: feasibility. Secondary outcomes: breathlessness (dyspnoea), fatigue, quality of life, physical function, sleep, tolerability and safety. Acceptability was also assessed through semi-structured interviews. Results: Fifteen participants were enrolled (mean age 73.6; 40% women; mean FEV |
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| Database: | Complementary Index |
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| Items | – Name: Title Label: Title Group: Ti Data: A mixed-methods pilot study of domiciliary nasal high-flow therapy for breathlessness in people with chronic obstructive pulmonary disease who do not qualify for domiciliary long-term oxygen therapy. – Name: Author Label: Authors Group: Au Data: <searchLink fieldCode="AR" term="%22Smallwood%2C+Natasha%22">Smallwood, Natasha</searchLink><br /><searchLink fieldCode="AR" term="%22Pascoe%2C+Amy%22">Pascoe, Amy</searchLink><br /><searchLink fieldCode="AR" term="%22Buchan%2C+Catherine%22">Buchan, Catherine</searchLink><br /><searchLink fieldCode="AR" term="%22Wong%2C+Aaron+K%2E%22">Wong, Aaron K.</searchLink><br /><searchLink fieldCode="AR" term="%22Currow%2C+David%22">Currow, David</searchLink><br /><searchLink fieldCode="AR" term="%22Le%2C+Brian%22">Le, Brian</searchLink> – Name: TitleSource Label: Source Group: Src Data: Therapeutic Advances in Respiratory Disease; 3/12/2025, p1-15, 15p – Name: Subject Label: Subject Terms Group: Su Data: <searchLink fieldCode="DE" term="%22CHRONIC+obstructive+pulmonary+disease%22">CHRONIC obstructive pulmonary disease</searchLink><br /><searchLink fieldCode="DE" term="%22OXYGEN+therapy%22">OXYGEN therapy</searchLink><br /><searchLink fieldCode="DE" term="%22AIR+flow%22">AIR flow</searchLink><br /><searchLink fieldCode="DE" term="%22MEDICAL+research%22">MEDICAL research</searchLink><br /><searchLink fieldCode="DE" term="%22PHYSICAL+mobility%22">PHYSICAL mobility</searchLink> – Name: Abstract Label: Abstract Group: Ab Data: Background: High-flow nasal oxygen (HFNO) therapy delivers humidified, heated air with flow rates of up to 60 L/min with oxygen entrained. HFNO has advantages over conventional oxygen therapy, including precise and reliable fraction of inspired oxygen delivery, therefore is recommended as first-line treatment for people with acute hypoxaemic respiratory failure. Objectives: This pilot study aimed to determine the feasibility and acceptability of domiciliary nasal high flow (NHF) without entrained oxygen for people with chronic obstructive pulmonary disease (COPD) and severe breathlessness. Design: Single-arm, mixed-methods, pilot study of an 8-day, air-only NHF intervention in adults with COPD and severe breathlessness not requiring domiciliary oxygen therapy. Methods: Participants were educated and advised to use NHF for ⩾7 h per night for 7 nights with day use as desired. Patient-reported outcome measures were assessed on Days 3, 5 and 8. Primary outcome: feasibility. Secondary outcomes: breathlessness (dyspnoea), fatigue, quality of life, physical function, sleep, tolerability and safety. Acceptability was also assessed through semi-structured interviews. Results: Fifteen participants were enrolled (mean age 73.6; 40% women; mean FEV<subscript>1</subscript> 41% predicted, mean DLCO 43.0% predicted; mean modified Medical Research Council score 3.7). Thirteen (87%) completed the trial, with 8 (54%) keeping the device at the end of the trial and 3 (20%) continuing use long-term. Adherence varied, with average daily usage higher amongst participants who kept the device compared to those who returned it (6.8 h ± 2.3 h vs 3.4 h ± 3.7 h). No changes in worst breathlessness (mean = 0.7, SD = 1.2, p = 0.109), dyspnoea mastery (mean = 0.3, SD = 0.6, p = 0.176) or fatigue (mean = 0.0, SD = 2.4, p = 1.00) were observed at Day 8 compared to baseline. No significant adverse events were reported. Qualitative interviews demonstrated subjective improvements in breathlessness, dry mouth and sputum production for some participants, whilst others found NHF uncomfortable. Fear of NHF dependence and concerns regarding long-term running costs were reported. Conclusion: Domiciliary NHF was a feasible intervention, albeit with varied adoption and acceptability. These trial implementation outcomes may have affected preliminary effectiveness outcomes. Further research is required to determine what role domiciliary NHF may have for people with COPD and severe breathlessness. Trial registration: ACTRN12621000044820. [ABSTRACT FROM AUTHOR] – Name: Abstract Label: Group: Ab Data: <i>Copyright of Therapeutic Advances in Respiratory Disease is the property of Sage Publications Inc. and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract.</i> (Copyright applies to all Abstracts.) |
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| RecordInfo | BibRecord: BibEntity: Identifiers: – Type: doi Value: 10.1177/17534666251314722 Languages: – Code: eng Text: English PhysicalDescription: Pagination: PageCount: 15 StartPage: 1 Subjects: – SubjectFull: CHRONIC obstructive pulmonary disease Type: general – SubjectFull: OXYGEN therapy Type: general – SubjectFull: AIR flow Type: general – SubjectFull: MEDICAL research Type: general – SubjectFull: PHYSICAL mobility Type: general Titles: – TitleFull: A mixed-methods pilot study of domiciliary nasal high-flow therapy for breathlessness in people with chronic obstructive pulmonary disease who do not qualify for domiciliary long-term oxygen therapy. Type: main BibRelationships: HasContributorRelationships: – PersonEntity: Name: NameFull: Smallwood, Natasha – PersonEntity: Name: NameFull: Pascoe, Amy – PersonEntity: Name: NameFull: Buchan, Catherine – PersonEntity: Name: NameFull: Wong, Aaron K. – PersonEntity: Name: NameFull: Currow, David – PersonEntity: Name: NameFull: Le, Brian IsPartOfRelationships: – BibEntity: Dates: – D: 12 M: 03 Text: 3/12/2025 Type: published Y: 2025 Identifiers: – Type: issn-print Value: 17534658 Titles: – TitleFull: Therapeutic Advances in Respiratory Disease Type: main |
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