OPTBreathe: Preference & cost-effective support for breathlessness
Research type
Research Study
Full title
OPTimizing cost-effective support for older patients with refractory BREATHlessness and their carers: An economic modelling evaluation incorporating preferences through Discrete Choice Experiment (OPTBreathe)
IRAS ID
223645
Contact name
Irene Higginson
Contact email
Sponsor organisation
Kings College London
Duration of Study in the UK
1 years, 11 months, 31 days
Research summary
Breathlessness is a common symptom affecting over 95% of people with non-cancer lung disease and 50-70% of those with cancer, most being in older age groups. Despite all the causes for breathlessness being treated, breathlessness often persists. Such “refractory” breathlessness is frightening, provokes panic, impairs quality of life and often results in emergency hospital attendance or admission.
Based on research with people affected by breathlessness, we developed a Breathlessness Support Service (BSS). This new short term service for patients and their families helps at an earlier stage than usual, bringing together palliative care and respiratory medicine. It included two outpatient visits and a home visit. A randomized controlled trial, supported by the National Institute for Health Research, found that BSS improved quality and length of life. Care costs did not increase. In parallel a similar breathlessness service was developed in Cambridge, which had similar benefits, with more home visits and no respiratory input. NHS commissioners are interested in BSS, but want to know more: what components are most valued by patients, would clinics be acceptable from GP surgeries, what is the broader economic impact.
Therefore, we use an economic research method to understand what aspects of a service patients would prioritize, combined with modelling. We ask 120 patients and where possible their families or caregivers to choose between attributes of BSS, indicating which are most important for them. Then we use this information in an economic model, adding cost estimates to the different ways of providing BSS (e.g. hospital outpatients, a GP surgery, at home) and what might be the savings for the NHS.
The study integrates at all stages guidance from people severely affected by breathlessness, and from NHS commissioners and health professionals. It provides vital information on the optimal ways to support people with breathlessness based on the priorities of people with breathlessness and the economic implications for NHS Commissioning Groups and funders.
REC name
West of Scotland REC 3
REC reference
17/WS/0083
Date of REC Opinion
17 May 2017
REC opinion
Further Information Favourable Opinion