Smallwood - Chronic Respiratory Disease

Key terms

Chronic obstructive pulmonary disease (COPD), pulmonary fibrosis, breathlessness, high flow therapy, non-pharmacological management, supportive care, models of care

Research goal

To investigate and develop new treatments and approaches to healthcare for people with COPD, pulmonary fibrosis and advanced lung diseases.

Honours and Postgraduate Research Projects

Our people

Lab Head

Senior Research Fellow
- A/Prof Rebecca Disler
Research Fellow
- Dr Amy Pascoe
Post-doctoral Research Assistant
- Dr Lena Ly
Research Assistants
- Ms Catherine Buchan
- Ms Stefanie Zappino
Affiliated researchers
- Dr Umbreen Qazi
- Dr Eleanor Beavis
PhD students
- Dr Anne Walker
- Dr Esther Chen
- Dr Julia Lachowicz
- Dr Sarah Yeo
- Ms Catherine Buchan
- Ms Stefanie Zappino
Research students
- In 2025 there are multiple junior doctors and medical students undertaking clinical research projects within the Chronic Respiratory Disease group including Cameron Exell and Harini Guddanti.

Clinical trial - participants sought

More about our research

Our research focuses on treatments and patient-centred care healthcare approaches for people experiencing with severe lung disease. Currently, we are leading a binational research and quality improvement program (the Australia & New Zealand Respiratory Audit Program (ANZRAP)) to generate high level data regarding healthcare access and quality for people with exacerbations of asthma or COPD. This data will be used to drive innovation and improve healthcare care outcomes in Australia and New Zealand. In addition, our group is leading research examining the role of domiciliary Nasal High Flow therapy to address breathlessness and cough in people with pulmonary fibrosis. We are also leading a five-year Medical Research Future Fund project to improve the recognition and management of chronic breathlessness in primary care. We have developed the INSPIRE: breathing better website to help patients, carers and health professionals to manage chronic breathlessness. As much of our previous research has identified that very few people with advanced lung disease access symptom support or palliative care, our research also focuses on health professional education needs and resources, collaborations with primary care, and new models of integrated care.
- 2025 - now: MRFF EMCR Grant – OVERNIGHT: A novel approach to reducing exacerbations for older people with COPD using HEPA filters (CIB - 4 years: $647,068) MRF2040672.
- 2023 - now: MRFF EMCR Grant - Nocturnal Oxygen with Telemonitoring in Fibrotic Interstitial Lung Disease Feasibility Evaluation Funding amount (NOTE-FY) (CIC - 2 years: $642,426) MRF2030893.
- 2023 - 2024: PACT Grant-In-Aid: A Phase II Randomised Crossover Trial to Assess Feasibility of Domiciliary Nasal High Flow for Chronic Breathlessness in People with Interstitial Lung Disease (INFINITE) (CIA - 1 year: $30,000).
- 2023 - 2024: Bethlehem Griffiths Research Foundation: Co-designing early palliative care for rural and chronic disease patients (CI – 1 year: $49,387)
- 2023 - now: MRFF Chronic Respiratory Conditions Grant - Treatable Traits in Interstitial Lung Disease (TTRILD) Study: The New Frontier (AI - 5 years: $1,999,323.20) MRF2022914.
- 2023-28: Medical Research Future Fund Chronic Respiratory Conditions Grant - Primary Breathe AUS: A primary care technology-enabled intervention to improve symptom self-management for people with chronic respiratory illness (CIA Smallwood - $1,977,834.10).
- 2021-23: Lord Mayors Charitable Foundation Innovation grant. Future proofing the frontline strategies to support frontline workers during times of crisis (CIA Smallwood - $300 000)
- 2021-26: NHMRC Investigator Grant (CIA Smallwood - 5 years: $650,000)
- 2021-27: ARC DECRA Fellowship Grant (CIA Disler – 6 years: $427,115) Dying well: Designing rural end of life services for chronic disease
- 2021: Lord Mayors Charitable Foundation grant. Australian COVID-19 Frontline Healthcare Workers Study (CIA Smallwood - $75 000)
- 2020: Melbourne Health Foundation – Australian COVID-19 Frontline Healthcare Workers Study (CIA Smallwood - $50 000)
- 2020-23: Windermere Foundation: Victorians at End of Life (VALE) Research Fellowship (CIA Smallwood - $450,000 with additional matched funding from the Centre for Palliative Care, Melbourne)
- 2019: University of Melbourne Seed Grant: Mapping palliative care for chronic disease in Northern Victoria (CIA Disler - $25,000)
- 2019: Fisher & Paykel Grant - EAGLE Nasal High Flow Feasibility Trial (CIA Smallwood - $43 000)
- 2018: University of Melbourne ECR Grant: Healthy brain ageing in chronic lung disease neuropsychological education program – Feasibility and acceptability study in rural Australia (CIA Disler - $40,000)

Major projects

‘SINFONIA’: A clinical trial examining the benefits of singing for breathing in COPD and ILD patients
This is a Phase 2/3 double-arm, randomised, mixed-methods intervention study of online singing group classes compared to standard care for people with COPD and pulmonary fibrosis. This study will allow us to determine the feasibility, acceptability, and effectiveness of online singing groups as an intervention for wellbeing and symptom management in participants with COPD and pulmonary fibrosis in Australia. Online delivery is important to determine feasibility and acceptability of alternative delivery models to improve accessibility and equity, particular in light of COVID-19 restrictions. Previous studies have shown some benefits to singing groups for COPD patients, but no randomized, controlled trials have been conducted in Australia or in participants with pulmonary fibrosis.
Find out more about SINFONIA: A clinical trial examining the benefits of SingINg For breathing in COPD aNd ILD pAtients
‘EAGLE’: A Phase 2 Trial to Assess Feasibility of Using Nasal High Flow for Breathlessness in Participants with Chronic Obstructive Pulmonary Disease who do not qualify for domiciliary long-term oxygen therapy
It is challenging to manage severe breathlessness in people with COPD and pulmonary fibrosis who do not have low oxygen levels, as treatment options are limited. This mixed methods research project, including feasibility and qualitative studies, will determine if domiciliary Nasal High Flow (NHF) therapy is a feasible and acceptable intervention for severe breathlessness in people with COPD or pulmonary fibrosis. Secondly these results will inform a world-first, multi-site Phase 3 RCT, to determine if long-term, domiciliary NHF is an effective and cost effective, new intervention for severe breathlessness in people who do not qualify for domiciliary continuous oxygen therapy.
INFINITE: A Phase II Randomised Crossover Trial to Assess Feasibility of Domiciliary Nasal High Flow for Chronic Breathlessness in People with Interstitial Lung Disease.
Interstitial lung disease (ILD) is a term for a group of lung conditions that are incurable, characterised by inflammation and scaring of the airways, persisting respiratory symptoms and progressive respiratory failure. Treatment options for people with ILD and severe breathlessness are limited. This mixed methods research project, including feasibility and qualitative studies, will determine if domiciliary Nasal High Flow (NHF) therapy is a feasible and acceptable intervention for severe breathlessness in people with ILD. Secondly these results will inform a world-first, multi-site Phase 3 RCT, to determine if long-term, domiciliary NHF is an effective and cost effective, new intervention for severe breathlessness in people who do not qualify for domiciliary continuous oxygen therapy.
Australian COVID-19 Frontline Healthcare Workers Study – Future proofing the frontline by developing strategies to support frontline workers during times of crisis
Pandemics, climate change and other disasters are now the ‘new normal’ for frontline workers globally. Phase 1 of this study was conducted as a cross-sectional survey of Australian frontline health workers (Aug-Oct 2020). From nearly 10 000 respondents, the largest multi-occupation survey globally, we identified: major detrimental mental health effects, financial and social disruption, work dissatisfaction and for many, a desire to leave the workforce. In Phase 2 of this study, we will utilise key learnings from the phase 1 results to develop solutions and recommendations in order to prepare for and respond to future crises (natural disasters, pandemics, impacts of climate change). This will include: co-designing and piloting support programs for leaders and workers; and developing policy and practice solutions to ‘future-proof’ the workforce.
Dying well: Designing rural end of life services for people with chronic disease
This program of work aims to understand how existing rural service structures impact access to end-of-life support in chronic conditions. Chronic diseases account for 90% of deaths in Australia, yet access to end-of-life support is limited and little is known about services in rural areas. Information gathered through patient and stakeholder interviews, national surveys and service mapping to generate a new evidence based framework and guideline. These outputs will support early engagement with end-of-life planning, known to improve quality of life and reduce health system costs, and to inform development of equitable future end-of-life services for people and their families living with chronic conditions across rural Australia.
PRIMARY BREATHE AUSTRALIA: A research program aiming to improve the recognition and management of people suffering from chronic breathlessness
Chronic breathlessness is considered a forgotten symptom, suffered by one in ten Australians. This 5-year research program aims to develop and trial an evidence-based, community-led breathlessness self-management intervention that will be codesigned together with patients, carers, and primary care health providers and delivered in the community to people living with chronic breathlessness. This program will culminate in a 2-year multi-site clinical trial across metropolitan and regional Victoria.
This is a binational research and quality improvement program in Australia and New Zealand, which will describe the current quality of care (including but not limited to access, availability and timeliness) received by patients with exacerbations of asthma or COPD, identify gaps in clinical care delivery and benchmark care against defined quality indicators in clinical care standards. This work will support and inform future quality improvement projects.

Department of Immunology

Medicine, Nursing and Health Sciences