Chronic Breathlessness Cohort Study
Research type
Research Study
Full title
An exploratory study in older adults presenting with undifferentiated chronic breathlessness to understand the future risk and potential prognostic factors of disability, impaired health status, healthcare utilisation, and mortality.
IRAS ID
235422
Contact name
Rachael Evans
Contact email
Sponsor organisation
Research Governance Operations Manager
Duration of Study in the UK
7 years, 10 months, 31 days
Research summary
Research Summary
Breathlessness is a common reason for people to see their General Practitioner (GP) or to be admitted to hospital. However, being short of breath is a normal response to physical exertion. Therefore deciding when the amount of breathlessness is abnormal for the level of exertion can be challenging for both individuals and GPs. Persistent breathlessness over at least two months is termed ‘chronic breathlessness’. There are many causes of chronic breathlessness, but it can take years before individuals are given a diagnosis. There is very little information about what happens to people from when they first go to their GP with chronic breathlessness. Doctors therefore have difficulty knowing who is at risk of getting worse over time.Patients who suffer from breathlessness tend to reduce physical exertion to avoid their symptoms. In some chronic lung diseases, this leads to further negative effects such as a change in leg muscle function, feelings of low mood or anxiety, and becoming slower physically. These negative effects could be linked to the symptom of breathlessness rather than specific diseases. Some doctors are using the term ‘chronic breathlessness syndrome’ but exactly what characterises this syndrome is unclear.
The main aim of this study is to understand the future health of individuals with chronic breathlessness. We wish to describe the features of people with chronic breathlessness and how these change over one year. These features include walking ability, muscle strength, balance, mobility and health-related quality of life. We hope to understand which features are important and which may need specific treatments. We want to understand which people are admitted to hospital or have a worse outcome so we can develop ways to improve the existing medical care received.
We also wish to understand if existing measures of balance and mobility are suitable and reliable in people with chronic breathlessness.
Questionnaires are used to assess the severity and impact of breathlessness and are usually reported as a score. This score can change with treatment. We want to describe what change in score reflects what patients perceive as a relevant change.
Summary of Results
The original study was discontinued due to very low recruitment for six months. A further study was designed to compare the future risk of developing heart problems and/or diabetes between adults with unexplained breathlessness and healthy controls. We recruited 10 breathless adults and 17 healthy controls and then the recruitment process had to be stopped following the national guidance for the COVID-19 lockdown. The results from this small sample showed that some measures that future risk of heart disease and/or diabetes was increased in the breathless group, but the sample size was too small to make any firm conclusions.The study inclusion criteria were amended to include adults recovering from severe COVID-19 and compare them with the healthy controls recruited from the first part of the study. This study found that 38 adults recovering from severe COVID-19 had a greater risk of developing heart problems and/or diabetes in the future compared to the 17 healthy controls. This risk was assessed using various methods including resting blood pressure, blood tests looking at glucose and a measure of arterial stiffness. All these measures were higher in the severe COVID-19 group which shows this group has a higher risk. It is unknown if the higher risk is the reason they had severe COVID-19 or if the viral infection causes an increase in future risk.
The original end of study was defined as follows:
1. Upon collection of the physical activity monitor after visit three, and 2. The collection of mortality data at five years for the last participant.However due to the circumstances following COVID-19, we are no longer collecting mortality data at 5 years. The study recruitment was stopped in November 2021 due to a time issue.
REC name
Wales REC 7
REC reference
18/WA/0022
Date of REC Opinion
18 Jan 2018
REC opinion
Favourable Opinion