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dc.contributor.authorHutchinson, A
dc.contributor.authorAllgar, V
dc.contributor.authorCohen, J
dc.contributor.authorCurrow, DC
dc.contributor.authorGriffin, S
dc.contributor.authorHart, S
dc.contributor.authorHird, K
dc.contributor.authorHodge, A
dc.contributor.authorMason, S
dc.contributor.authorNorthgraves, M
dc.contributor.authorReeve, J
dc.contributor.authorSwan, F
dc.contributor.authorJohnson, MJ
dc.date.accessioned2022-10-28T12:41:27Z
dc.date.available2022-10-28T12:41:27Z
dc.date.issued2022-08-24
dc.identifier.issn2312-0541
dc.identifier.issn2312-0541
dc.identifier.otherARTN 00257-2022
dc.identifier.urihttp://hdl.handle.net/10026.1/19776
dc.description.abstract

<jats:sec><jats:title>Introduction</jats:title><jats:p>One-fifth of emergency department presentations by ambulance are due to acute-on-chronic breathlessness. We explored the feasibility of an evaluation-phase, cluster randomised controlled trial (cRCT) of the effectiveness and cost-effectiveness of a paramedic-administered, non-pharmacological breathlessness intervention for people with acute-on-chronic breathlessness at ambulance call-out (BREATHE) regarding breathlessness intensity and conveyance to hospital.</jats:p></jats:sec><jats:sec><jats:title>Methods</jats:title><jats:p>This mixed-methods, feasibility cRCT (<jats:ext-link xmlns:xlink="http://www.w3.org/1999/xlink" ext-link-type="isrctn" xlink:href="80330546">ISRCTN80330546</jats:ext-link>), randomised paramedics to usual care or intervention plus usual care. Retrospective patient consent to use call-out data (primary endpoint) and prospective patient/carer consent for follow-up was sought. Potential primary outcomes included breathlessness intensity (numerical rating scale) and conveyance. Follow-up included: interviews with patients/carers and questionnaires at 14 days, 1 and 6 months; paramedic focus groups and surveys.</jats:p></jats:sec><jats:sec><jats:title>Results</jats:title><jats:p>Recruitment was during COVID-19, with high demands on paramedics and fewer call-outs by eligible patients. We enrolled 29 paramedics; nine withdrew. Randomisation/trial procedures were acceptable.</jats:p><jats:p>Paramedics recruited thirteen patients, not meeting recruitment target (n=36); eight patients and three carers were followed up. Data quality was good but insufficient for future sample size estimation.</jats:p><jats:p>The intervention did not extend call-out time, was delivered with fidelity and was acceptable to patients, carers and paramedics. There were no repeat call-outs within 48 h. All trained paramedics strongly recommended BREATHE as a highly relevant, simple intervention.</jats:p></jats:sec><jats:sec><jats:title>Conclusion</jats:title><jats:p>Patient recruitment to target was not feasible during the pandemic. Training and intervention were acceptable and delivered with fidelity. Results include valuable information on recruitment, consent, attrition, and data collection that will inform the design and delivery of a definitive trial.</jats:p></jats:sec>

dc.format.extent00257-2022
dc.format.mediumElectronic-eCollection
dc.languageen
dc.language.isoen
dc.publisherEuropean Respiratory Society
dc.subject32 Biomedical and Clinical Sciences
dc.subject3202 Clinical Sciences
dc.subjectClinical Research
dc.subjectClinical Trials and Supportive Activities
dc.subject7 Management of diseases and conditions
dc.subject7.3 Management and decision making
dc.subject3 Good Health and Well Being
dc.titleMixed-methods feasibility cluster randomised controlled trial of a paramedic-administered breathlessness management intervention for acute-on-chronic breathlessness (BREATHE): Study findings
dc.typejournal-article
dc.typeArticle
plymouth.author-urlhttps://www.ncbi.nlm.nih.gov/pubmed/36415651
plymouth.issue4
plymouth.volume8
plymouth.publisher-urlhttp://dx.doi.org/10.1183/23120541.00257-2022
plymouth.publication-statusPublished
plymouth.journalERJ Open Research
dc.identifier.doi10.1183/23120541.00257-2022
plymouth.organisational-group/Plymouth
plymouth.organisational-group/Plymouth/Faculty of Health
plymouth.organisational-group/Plymouth/Faculty of Health/Peninsula Medical School
plymouth.organisational-group/Plymouth/REF 2021 Researchers by UoA
plymouth.organisational-group/Plymouth/REF 2021 Researchers by UoA/UoA01 Clinical Medicine
plymouth.organisational-group/Plymouth/Research Groups
plymouth.organisational-group/Plymouth/Research Groups/Plymouth Institute of Health and Care Research (PIHR)
plymouth.organisational-group/Plymouth/Users by role
plymouth.organisational-group/Plymouth/Users by role/Academics
dc.publisher.placeEngland
dcterms.dateAccepted2022-08-11
dc.rights.embargodate2022-10-29
dc.identifier.eissn2312-0541
dc.rights.embargoperiodNot known
rioxxterms.versionofrecord10.1183/23120541.00257-2022
rioxxterms.licenseref.urihttp://www.rioxx.net/licenses/all-rights-reserved
rioxxterms.typeJournal Article/Review


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