Interstitial lung disease fatigue and breathlessness (ILD-FAB) programme: a multidisciplinary feasibility study

Background Fatigue, breathlessness and cough are prevalent symptoms of interstitial lung disease (ILD) adversely impacting quality of life and contributing to psychological distress. The fatigue and breathlessness (FAB) programme facilitates supported self-management for people living with life-limiting conditions. We explore its utility when adapted for people living with ILD. Methods The 4-week ILD-FAB programme offers each group (n=≤6) weekly 2-hour sessions led by an ILD-specialist physiotherapist and clinical nurse specialist (CNS). Primary focus is on strategies to manage breathlessness, fatigue and well-being. Further, a 1:1 session with the ILD-CNS enables participants to set personalised goals and explore individual health beliefs/behaviours using a cognitive behavioural therapy assessment framework. The self-reporting chronic respiratory questionnaire (CRQ-SR) evaluates breathlessness, fatigue, emotional function and mastery at baseline and after 4 weeks. We facilitated 11 groups between March 2023 and December 2024. Results 49 participants (26 males; median age 76 years (IQR=14)) were diagnosed with idiopathic pulmonary fibrosis (n=21), progressive pulmonary fibrosis (n=17) or non-progressive ILD (n=11) of various aetiologies. Lung function indicated a range of disease severity (FVC % predicted median: 70% (IQR=34); DLCO % predicted median: 42% (IQR=30)). 37 (76%) participants attended all four sessions, 6 (12%) attended three sessions, 2 (4%) attended two sessions and 4 (8%) attended one session. 37 patients, all of whom attended at least three sessions, completed the CRQ-SR at baseline and week 4. 59% of respondents (n=22) demonstrated clinically significant improvements in dyspnoea scores, 51% (n=19) in emotional functioning scores and 49% (n=18) in fatigue and mastery scores. 35 respondents (95%) demonstrated a clinically significant improvement in at least one domain. All participants (100%) would recommend this programme to others. Conclusion These data demonstrate feasibility, acceptability and clinical effectiveness of an ILD-specific FAB programme. Further research will explore a range of outcome measures longitudinally in a larger cohort.