Pursed lip breathing for Airflow Obstruction, Chronic

Phase-Based Progress Estimates
1
Effectiveness
1
Safety
VA Boston Healthcare System Jamaica Plain Campus, Jamaica Plain, MA, Boston, MA
Airflow Obstruction, Chronic+2 More
Pursed lip breathing - Behavioral
Eligibility
18+
All Sexes
Eligible conditions
Select

Study Summary

This study is evaluating whether a program which helps patients with COPD breathe better may help reduce the use of oxygen.

See full description

Eligible Conditions

  • Airflow Obstruction, Chronic

Treatment Effectiveness

Effectiveness Estimate

1 of 3

Study Objectives

This trial is evaluating whether Pursed lip breathing will improve 1 primary outcome and 11 secondary outcomes in patients with Airflow Obstruction, Chronic. Measurement will happen over the course of Through study completion, an average of 12 weeks.

12 weeks
Discontinuation of Oxygen at 12 weeks
Week 12
Acceptability to patients
Acceptability to providers
Cost of intervention
Proportion of participants completing in-home spirometry
Proportion of participants completing tele-6MWT
Proportion of potentially eligible participants randomized
Proportion of randomized participants completing 12 week follow up
Week 12
Clinical COPD Questionnaire (CCQ) Total Score
Post tele-six minute walk test (tele-6MWT) Borg Dyspnea scale
Rate of completion of all visits
tele-six minute walk test distance (tele-6MWT)

Trial Safety

Safety Estimate

1 of 3

Trial Design

2 Treatment Groups

Usual Care
1 of 2
De-implementation Intervention
1 of 2
Active Control
Experimental Treatment

This trial requires 48 total participants across 2 different treatment groups

This trial involves 2 different treatments. Pursed Lip Breathing is the primary treatment being studied. Participants will all receive the same treatment. There is no placebo group. The treatments being tested are not being studied for commercial purposes.

De-implementation InterventionThe oxygen de-implementation intervention will consist of: 1) an order to rescind the patient's home oxygen 2) an "unlearning" component targeting provider and patient education and 3) a "substitution" component that introduces alternative evidence-based therapies to treat dyspnea (e.g. teach-to-goal inhaler teaching and pursed lip breathing).
Usual CareThe patient receives usual care from their assigned clinical provider.
Treatment
First Studied
Drug Approval Stage
How many patients have taken this drug
Provider Education
2015
N/A
~1740
Patient Education
2018
N/A
~2630
Pursed lip breathing
2016
N/A
~100

Trial Logistics

Trial Timeline

Approximate Timeline
Screening: ~3 weeks
Treatment: Varies
Reporting: 12 weeks
This trial has the following approximate timeline: 3 weeks for initial screening, variable treatment timelines, and roughly 12 weeks for reporting.

Closest Location

VA Boston Healthcare System Jamaica Plain Campus, Jamaica Plain, MA - Boston, MA

Eligibility Criteria

This trial is for patients born any sex aged 18 and older. There are 10 eligibility criteria to participate in this trial as listed below.

Mark “yes” if the following statements are true for you:
Age 40 years or older
Diagnosis of COPD
Discharged within the past 3 months after hospitalization for COPD exacerbation, congestive heart failure exacerbation and/or pneumonia
Active prescription for supplemental oxygen within 48 hours of discharge that remains active
No inpatient or outpatient exacerbations of COPD within the last 30 days
Smoked at least 10 pack-years of cigarettes
Room air resting saturation >88% on room air
Spirometry consistent with COPD (FEV1/FVC < 0.70) and/or evidence of emphysema on CT scan
Willingness on the part of the participant to stop oxygen if randomized to the intervention
Ability and willingness to participate in virtual video visits with study staff using VA approved software

Patient Q&A Section

What are common treatments for airflow obstruction, chronic?

"Both bronchodilators and pulmonary rehabilitation, or a combination of both, may provide significant improvements in the quality of life in patients with moderate to severe airflow obstruction. Pulmonary rehabilitation also demonstrated a significant improvement in lung function in patients with severe airflow obstruction." - Anonymous Online Contributor

Unverified Answer

What is airflow obstruction, chronic?

"It is estimated that COPD affects about 17 million people in the U.S.; however COPD remains under-diagnosed. Findings from a recent study presents one approach to the identification and screening of the elderly for COPD." - Anonymous Online Contributor

Unverified Answer

How many people get airflow obstruction, chronic a year in the United States?

"The American Cancer Society estimates 18,000 new cases of chronic airflow obstruction will be diagnosed in 2019. Older age, male sex, and cigarette smoking are risk factors for chronic airflow obstruction, chronic. The prevalence of chronic airflow obstruction, chronic is higher in men from southern states, non-Hispanic whites, and those of lower incomes." - Anonymous Online Contributor

Unverified Answer

What are the signs of airflow obstruction, chronic?

"airflow obstruction is typically marked by an increased respiratory rate and dyspnea. Signs include orthopnea and shortness of breath. Fibreoptic bronchoscopy, chest radiography and sputum analysis are often needed to elucidate the presence and severity of airflow obstruction." - Anonymous Online Contributor

Unverified Answer

Can airflow obstruction, chronic be cured?

"In chronic airflow obstruction with airflow resistance less than half of the predicted values, bronchodilators produce major clinical improvement in terms of symptoms and lung function but not necessarily in terms of lung-function reversibility. In this population, lung-function reversibility is not associated, on average, with clinical improvement in symptoms. The role of bronchodilators in irreversible chronic airflow obstruction is not established." - Anonymous Online Contributor

Unverified Answer

What causes airflow obstruction, chronic?

"The most common cause of persistent airflow obstruction is airflow obstruction, chronic, that is due to airway disease. As the prevalence of chronic airflow obstruction was 8.7% in the general population, this implies that 1 in 12 adults is affected by airflow obstruction, chronic." - Anonymous Online Contributor

Unverified Answer

What is the average age someone gets airflow obstruction, chronic?

"Approximately 1 in 4 adults with airflow obstruction, chronic suffer chronic airflow failure. It is not known what the average age of symptoms onset is but most adults present with symptoms in their twenties. The diagnosis of airflow obstruction, chronic is suspected in most adults upon examining the symptoms. Because the incidence of airflow obstruction, chronic rises as people age, it can occur at any age and thus, may be over-diagnosed in the elderly." - Anonymous Online Contributor

Unverified Answer

How does pursed lip breathing work?

"Pursed lip breathing is effective in relieving respiratory symptoms, in comparison with normal respiration, in both children and adults with persistent airway obstruction, such as bronchial asthma." - Anonymous Online Contributor

Unverified Answer

What are the latest developments in pursed lip breathing for therapeutic use?

"Pursed-lip breathing provides significant improvements in pulmonary function by reducing the number of sputum and the amount of air exchanged, as well as increasing lung volume and diffusion capacity of the lung for carbon dioxide. The use of the puffed nasal air spray with PLS (Pulse Locks System) offers greater advantages due to its more vigorous, more targeted, and constant application of pressure than those of the standard nasal spray. If PLS is used when the patient complains of discomfort after the nose-breathing maneuver, improvement of the symptoms will be observed. Further investigation of the effects of the use of PLS with PLS on pulmonary function in patients with OSA is warranted." - Anonymous Online Contributor

Unverified Answer

Have there been other clinical trials involving pursed lip breathing?

"Although PLB had a low rate of success (12.7%) for treating chronic obstructive airway disease (COPD) we found evidence of increased success for treating OSA." - Anonymous Online Contributor

Unverified Answer

Does pursed lip breathing improve quality of life for those with airflow obstruction, chronic?

"Plessiedeleer-van Steyn breathed through a specialised nasal mask during inspiratory exercises, as compared to the use of a nasal mask during inspiratory exercises only. Plessiedeleer-Van Steyn found her quality of life improved with the use of purse lip breathing." - Anonymous Online Contributor

Unverified Answer

What is the latest research for airflow obstruction, chronic?

"There's more research to do. Researchers around the globe continue to work on finding better treatments for patients with chronic airflow obstruction. There's still much to learn. Researchers are working to better understand how the immune system and the airway work together so there are better medications in the future. It will also help to better understand the role of the airway in diseases like COPD. Power, you can find latest research here. Please think of how you can get better treatment for your patient through research. Please check this website to make sure you have the latest and the most up-to-date information on airflow obstruction, chronic." - Anonymous Online Contributor

Unverified Answer
Please Note: These questions and answers are submitted by anonymous patients, and have not been verified by our internal team.
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