An online breathing and wellbeing programme (ENO Breathe) for people with persistent symptoms following COVID-19: a parallel-group, single-blind, randomised controlled trial

Philip, Keir; Owles, Harriet; McVey, Stephanie; Pagnuco, Tanja; Bruce, Katie; Brünjes, Harry; Banya, Winston; Mollica, Jenny; Lound, Adam; Zumpe, Suzi; Abrahams, Amiad M; Padmanaban, V; Hardy, T.; Lewis, Adam; Lalvani, Ajit; Elkin, Sarah; Hopkinson, Nicholas S

doi:10.1016/s2213-2600(22)00125-4

Cited by 62 publications

(141 citation statements)

References 37 publications

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“…In addition, our study reports that speech-language therapists and public health professionals use telehealth the most in their clinical practices (98% and 95%, respectively), perhaps due to the high demand for telehealth solutions among these professions [ 23 , 35 ]. Concerning speech-language therapy, therapies such as “singing for lung health” or “breathing exercise” are mostly provided using telehealth as they are flexible solutions [ 36 , 37 ].…”

Section: Discussionmentioning

confidence: 99%

Healthcare Providers’ Perception and Barriers Concerning the Use of Telehealth Applications in Saudi Arabia: A Cross-Sectional Study

et al. 2022

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Background: Telehealth services are widely used in Saudi Arabia. Despite this, neither the use rate nor the attitudes, perceptions, and barriers concerning telehealth applications have been evaluated nationally from the perspective of healthcare providers (HCPs). Aim: This study aims to explore the use rate of telehealth, as well as the attitudes, perceptions, and barriers concerning telehealth use in Saudi Arabia from the perspective of HCPs. Methods and design: A cross-sectional survey was conducted and distributed to all HCPs between 16 November 2021 and 16 March 2022, through an online platform (Survey Monkey). Results: Overall, 1034 HCPs completed the online survey, of which 65.0% (n = 677) were male. Physicians accounted for 22.34%, while nurses and respiratory therapists accounted for 22.34% and 21.47%, respectively. Only 491 HCPs (47%) have used telehealth applications, the majority for less than a year (21.47%) or from one to three years (14.51%). Around 44% of HCPs perceived telehealth as being useful in quality and care delivery. Around 43% of HCPs felt comfortable using telehealth, and 45.45% perceived telehealth as being useful for patients with transportation difficulties. Additionally, 38% believed that telehealth provides a confidential way of protecting patients’ information, and 36% would like to receive more training in telehealth. Speech-language therapists and public health professionals were the highest HCP users (98% and 95%, respectively), while general physicians and dentists were the lowest users (44% and 55%, respectively). Lack of time or a busy schedule was the most common barrier to not using telehealth among all HCPs (38%). Conclusion: The use of telehealth was perceived as being positive as well as valuable and confidential in monitoring and providing care. However, challenges such as the lack of time or a busy schedule impeded the use of telehealth among HCPs in Saudi Arabia.

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Section: Discussionmentioning

confidence: 99%

Healthcare Providers’ Perception and Barriers Concerning the Use of Telehealth Applications in Saudi Arabia: A Cross-Sectional Study

et al. 2022

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“…In The Lancet Respiratory Medicine, Keir Philip and colleagues 5 report their findings from a randomised controlled trial of an online wellbeing and breathing programme (English National Opera [ENO] Breathe), developed by the ENO learning and participation team alongside clinicians. This programme focuses on breathing retraining using singing techniques, and is delivered via an online platform.…”

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confidence: 99%

“…Singing techniques have demonstrated improvements in conditions such as chronic obstructive pulmonary disease (COPD) for health-related quality of life and exercise capacity, and the evidence for this is increasing. 6 , 7 Philip and colleagues 5 found improvements in elements of breathlessness and mental wellbeing for individuals with breathlessness following SARS-CoV-2 infection and, as a result, suggest that ENO Breathe provides a flexible and suitable strategy for managing some of the lasting symptoms of COVID-19. Access to this intervention can provide health-care professionals with a useful tool to aid recovery and can supplement routine care.…”

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confidence: 99%

Treating COVID-19-related breathlessness with novel interventions

Daynes

2022

The Lancet Respiratory Medicine

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“…Online delivery represents a major hurdle in delivery of this intervention and it is unclear whether online group singing can facilitate comparable social connection opportunities and thus overall benefits. A similar singing intervention has been delivered entirely online over six weeks to participants experiencing persistent symptoms following COVID-19 infection (long COVID-19) in the UK, with singing resulting in an improvement in the mental health component of the SF-36 when compared with usual care [54]. These results are promising, however the mean age of long COVID-19 patients in that study is considerably lower than that of other ALD patients participating in face-to-face group singing (49 vs 71 years) [32].…”

Section: Discussionmentioning

confidence: 99%

SINFONIA study protocol: a phase II/III randomised controlled trial examining benefits of guided online group singing in people with chronic obstructive pulmonary disease and interstitial lung disease and their carers

et al. 2022

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Background Chronic obstructive pulmonary disease (COPD) and interstital lung disease (ILD) are incurable conditions characterised by airflow limitation, persisting respiratory symptoms, and progressive respiratory failure. People living with COPD or ILD often suffer from chronic and severe breathlessness, with limited treatment options and low engagement rates with current therapies. Group singing represents a potential community-based therapy to improve quality of life for patients with COPD or ILD and breathlessness. Methods This protocol papers describes SINFONIA, a parallel, double-arm, randomised, blinded-analysis, mixed-methods phase II/III trial of guided, online group singing that will be conducted over 24 months. Adults with confirmed COPD or ILD, on stable treatment for at least four weeks at time of recruitment, with a modified Medical Research Council (mMRC) dyspnoea score of two or greater, who are capable and willing to give consent, and not currently participating in pulmonary rehabilitation will be eligible to participate. Carers may optionally enrol in the trial. Data will be collected on quality of life, anxiety and depression, breathlessness, mastery of breathing, exercise tolerance, loneliness, healthcare utilisation, and carer quality of life (optional). Participants will be randomised 1:1 to intervention or control arms with intervention arm attending one 90 min, guided, online, group singing session per week for 12 weeks and control arm continuing routine care. Phase II of the trial aims to determine the feasibility and acceptability of guided, online group singing and will collect preliminary data on effectiveness. Phase III aims to determine whether guided, online group singing has an effect on quality of life with the primary outcome being a between arm difference in quality of life (36-item Short Form Survey) measured at 12 weeks. Discussion SINFONIA is the first study is the first of its kind in Australia and to our knowledge, the first to deliver the singing intervention program entirely online. Determining the feasibility, acceptability, and effectiveness of guided, online group singing is an important step towards improving low-cost, low-risk, community-based therapeutic options for patients living with COPD or ILD and breathlessness. Trial registration: Phase II—ACTRN12621001274864, registered 20th September 2021; Phase III—ACTRN12621001280897, registered 22nd September 2021.

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An online breathing and wellbeing programme (ENO Breathe) for people with persistent symptoms following COVID-19: a parallel-group, single-blind, randomised controlled trial

Cited by 62 publications

References 37 publications

Healthcare Providers’ Perception and Barriers Concerning the Use of Telehealth Applications in Saudi Arabia: A Cross-Sectional Study

Healthcare Providers’ Perception and Barriers Concerning the Use of Telehealth Applications in Saudi Arabia: A Cross-Sectional Study

Treating COVID-19-related breathlessness with novel interventions

SINFONIA study protocol: a phase II/III randomised controlled trial examining benefits of guided online group singing in people with chronic obstructive pulmonary disease and interstitial lung disease and their carers

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