How GPs can help patients with breathlessness
Letter from Dr Noel Baxter, GP and honorary medical adviser for the British Lung Foundation
With the British Lung Foundation (BLF) launching its Listen to your Lungs campaign on Thursday, doctors might find more patients requesting further investigation. The charity is encouraging people not to ignore feeling breathless doing everyday tasks and to take a simple online breath test to see if they might need expert medical advice.
What should we, as GPs, do to help and reassure patients about their lung health?
Our response to the presentation of breathlessness should be measured, with considerations around the need for specialist organ system support. There are general clinical care pathways for treating the more common conditions such as COPD, asthma and heart failure and these should be used as a guide.
Depending on the cause, and how advanced the condition is, a range of responses are open to us:
- Prescribe physical activity, cardiac and pulmonary rehabilitation (PR);
- Promote and provide an annual flu vaccination as a core part of the treatment plans;
- Help patients live with breathlessness by ensuring they see a symptoms expert;
- Support patients with treatments recommended by specialist colleagues;
- Treat anxiety and depression.
Dealing with anxiety and depression can create new and unexpected social opportunities. Do you have a local patient choir? We know singing reduces anxiety, lengthens the out-breath, and reduces sensitivity to breathlessness. If you don’t have such a group, lobby your joint commissioners to get one set-up.
The British lung Foundation already runs a number of singing groups.
If we do see an influx of patients, we should be prepared: Complete a structured diagnostic assessment (as suggested by Impress), considering that people may have multiple causes, and then work with the patient prioritising the goals that are important to them.
You can see the online breath test here.