Investigating a structured diagnostic approach for chronic breathlessness in primary care: a mixed-methods feasibility cluster randomised controlled trial

Investigating a New Approach for Chronic Breathlessness in Primary Care

Background

We want to shorten the time it takes to diagnose chronic breathlessness to help patients feel better sooner.

Objective

This study examines whether a structured approach to diagnosing chronic breathlessness is more effective than standard care in primary care settings.

Methods

We worked with 10 general practices, dividing them into two groups. One group followed a structured diagnostic approach, including early tests, while the other group continued with usual care. We included adults over 40 who had chronic breathlessness without a known cause. We focused on how many participants we could recruit and keep in the study after one year. We also looked at the number of tests done and patient feedback over time.

Results

We recruited 32% of our target (48 out of 150), with an average age of 66 years and a high retention rate of 85% after one year. The intervention group had more tests at three months (8 tests) compared to the usual care group (5 tests). At the end of the study, 44% of the intervention group received a diagnosis for their breathlessness, compared to 26% in usual care. Patients in the intervention group reported improvements in their symptoms and quality of life.

Conclusions

This study shows that a structured diagnostic approach for chronic breathlessness can work well in primary care, leading to faster diagnoses and better patient-reported outcomes. We recommend a larger study to confirm these findings and look at the costs involved.

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