Exacerbation Prevention in chronic obstructive pulmonary disease (COPD) - using High Flow Therapy at home to reduce hospital readmission (EPIC-HFT UK)
Chronic obstructive pulmonary disease (COPD) is a long-term lung condition that makes breathing difficult. Sudden flare-ups can become serious enough to need hospital treatment. Even after going home, severe breathlessness often makes daily life hard and increases the risk of being readmitted. This trial investigates whether a device called high-flow therapy can help patients recover more smoothly at home. The machine delivers warm, moist air gently into the nostrils. Patients admitted to hospital with a COPD flare-up are placed into one of two groups: one continues with standard NHS treatment alone, while the other receives standard care plus the home breathing device. The research team will follow participants for 12 months after they leave hospital to see if the device reduces flare-ups, eases breathing, and cuts down on hospital readmissions. Normal medications, such as inhalers, are continued throughout.
At a glance
What is this study about?
Chronic obstructive pulmonary disease (COPD) is a common lung condition that causes long-term breathing problems. People living with COPD can experience sudden flare-ups, also known as exacerbations, where coughing, phlegm, and breathlessness quickly get worse. In severe cases, patients need to stay in hospital to help their breathing recover.
Leaving hospital is an important milestone, but recovery can be difficult. Many people continue to struggle with severe breathlessness that limits everyday tasks like walking, washing, or preparing meals. Even with standard treatments—such as inhalers, steroid tablets, and antibiotics—there is a high risk of another flare-up and needing hospital care again within a year.
This study, called EPIC-HFT UK, is exploring whether a treatment called nasal high-flow therapy can help. The device warms and moistens air before gently pumping it through small, soft prongs placed in the nose. Early research shows this therapy can help clear mucus and ease breathing in people with stable COPD. Researchers now want to find out if using this machine at home helps people stay healthier and out of hospital during the year following a severe flare-up.
Key takeaways
- Tests whether a home high-flow breathing machine prevents hospital readmissions for COPD.
- Open to adults aged 40 and older currently admitted to hospital with a COPD flare-up.
- Compares standard NHS COPD treatment against standard care plus the home breathing device.
- Involves regular check-ins and support from the study team for 12 months after discharge.
- Completely voluntary, safe, and designed to run alongside your usual prescribed medications.
Who may be eligible?
This study is designed for adults aged 40 and older who have been admitted to hospital because of a severe COPD flare-up. To qualify, you must have an established medical diagnosis of COPD confirmed by standard breathing tests, and a past or current history of smoking (equal to at least 10 pack-years, such as smoking 20 cigarettes a day for 10 years).
You may not be eligible if you already use certain home breathing machines, such as CPAP or NIV for sleep apnoea. The trial is also not suitable for people with severe obesity (a body mass index over 35) or other serious long-term medical conditions that could independently cause hospital readmissions or severe illness over the next 12 months.
Could this study suit you?
Answer these quick questions to see if you may be eligible. This is a guide only — the research team makes the final call.
- I am 40 years of age or older.
- I am currently in hospital due to a flare-up of my COPD.
- I have a confirmed COPD diagnosis and a smoking history of at least 10 pack-years.
- I do not already use a CPAP or NIV breathing machine at home.
- My body mass index (BMI) is 35 or lower.
What does participation involve?
You will be approached to take part while you are still in hospital for your COPD flare-up. If you agree, you will be randomly assigned to either receive your normal COPD care alone, or your normal care plus the home high-flow breathing machine. The team will gather standard health information from your hospital records, such as your height, weight, vital signs, and past test results. After you return home, the study team will keep in touch and monitor your progress over 12 months. Follow-up includes regular check-ins, simple walking and breathing tests, and wearing an activity monitor. No extra routine blood tests are required for the main study. In total, your participation lasts for one year after leaving hospital.
Potential risks and benefits
Locations (1)
- Guy's and St Thomas' HospitalsCity onlyLondon, England
Common questions
Will I have to stop taking my regular COPD medicines?
No. You will continue taking all your prescribed inhalers, steroids, or other medicines just as you normally do.
Is the high-flow machine uncomfortable or noisy?
Most patients find high-flow therapy soothing and comfortable because the air is warmed and humidified before it enters the nose.
Do I have to pay for the breathing device?
No. The device and all related supplies are provided entirely free of charge for the study.
What happens if I decide I no longer want to take part?
Taking part is completely voluntary. You can stop at any time, and your normal NHS care will carry on unchanged.
Will taking part require painful blood tests?
The main study does not require any extra blood tests beyond your normal hospital care. Any specialised blood tests offered are entirely optional.
How to find out more
Gill Radcliffe
Always speak to your GP or specialist before deciding to take part in a study.
Interested in taking part?
Discussion
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