The FAFA (FAn on FAce) trial: A randomized clinical trial on the effect of a fan blowing air on the face to relieve dyspnea in Filipino patients with terminal cancer

Abstract

Abstract Background Dyspnea is a very common distressing symptom in patients with advanced stages of cancer. Fan therapy has been suggested by some studies as a non-pharmacological intervention to alleviate breathlessness in addition to the prescribed standard of care. Unfortunately data among Asians is very limited, and there are currently no published studies showing that this intervention works among Filipinos –thus this study. Methods This study is an open, randomized, placebo-controlled, crossover phase 2 trial. The experimental group had a fan blowing air directly to the patient’s face for five minutes, and the control group had a fan blowing air to the patient’s legs. Treatment cross-over was done after a wash-out period of one hour. The primary outcome which is dyspnea was measured subjectively using the Modified Borg Scale (MBS), and objectively using the patient’s respiratory rate (RR) and oxygen saturation (SaO2). Results A total of 48 patients were enrolled in this trial. The mean age of the patients enrolled was 51 years old, and the most common primary tumor sites were lung, breast, and osteosarcoma. More than two-thirds of the participants had pneumonia and had an ECOG performance status of 4. 29% of the patients were intubated. T-test was used for analysis. In the control group, results showed that the mean difference before and after intervention in the MBS was 0.15, mean difference in RR was 0.25, and mean SaO2 difference was 0.10. On the other hand, the intervention group showed a statistically significant decrease in the patient’s dyspnea as evidenced by a mean MBS decrease of 2.79, mean RR decrease of 1.88, and a mean SaO2 improvement of 0.67 (p value Conclusions The results of this study reveal that blowing air from an electric fan directly on the face of terminally ill Filipino cancer patients in addition to the prescribed standard of care significantly alleviated their level of dyspnea as evidenced by improvements in their modified Borg scale score, respiratory rate, and oxygen saturation. Thus, fan on face therapy should be considered as an adjunct to standard of care for these patients. Clinical trial identification University of the Philippines - Manila Research Ethics Board (UPMREB) No. 2019-050-01. Legal entity responsible for the study The authors. Funding Has not received any funding. Disclosure All authors have declared no conflicts of interest.