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.