Background Anxiety is common in patients who experience breathlessness due to advanced chronic respiratory disease. 1 in 3 patients with COPD will have significant anxiety, as will 21% of patients with interstitial lung disease, and this increases as symptom burden worsens. This is associated with poor health outcomes for patients, including higher frequency of exacerbations and hospitalisations. Neuromodulation using cranial electrotherapy stimulation (CES) reduces anxiety in patients with generalised anxiety disorder, however has not been investigated in patients with anxiety related to breathlessness. We aimed to explore patients’ views on the potential use of neuromodulation through Patient and Public Involvement (PPI) work, to guide development of a pilot study of this novel intervention.
Methods We invited patients attending outpatient and day therapy services at LOROS Hospice with advanced chronic respiratory disease to give their opinions on CES generally and on the design of a study to evaluate it as a treatment for anxiety in breathlessness. Presentations were also given to a panel of hospice PPI research consultees.
Results 9 patients agreed to a conversation with a member of the LOROS Research Team, and most self-identified as experiencing anxiety to varying degrees. Two-thirds of patients agreed they would be interested in participating in a study involving neuromodulation. One patient was unsure, and two patients would not participate due to fears around electrical current and ‘machine-burden’. Common questions from patients included mechanism of action, sensation of using the device, and whether there would be any improvement in their breathlessness. PPI panellists agreed that neuromodulation is an acceptable intervention and an important area for research.
Conclusion This PPI work supports the development of a pilot study using neuromodulation to manage anxiety in patients who experience breathlessness due to advanced chronic respiratory disease.
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