Management of chronic breathlessness in primary care: what do GPs, non-GP specialists, and allied health professionals think?
Anthony Sunjaya
A B * , Allison Martin A B , Clare Arnott B C and Christine Jenkins A B *
+ Author Affiliations
- Author Affiliations
A Respiratory Program, The George Institute for Global Health, Sydney, NSW 2050, Australia.
B Faculty of Medicine, University of New South Wales, Sydney, NSW 2052, Australia.
C Cardiovascular Division, The George Institute for Global Health, Sydney, NSW 2050, Australia.
* Correspondence to: asunjaya@georgeinstitute.org.au, christine.jenkins@sydney.edu.au
Australian Journal of Primary Health 29(4) 375-384 https://doi.org/10.1071/PY22018
Submitted: 4 February 2022 Accepted: 19 December 2022 Published: 23 January 2023
© 2023 The Author(s) (or their employer(s)). Published by CSIRO Publishing on behalf of La Trobe University. This is an open access article distributed under the Creative Commons Attribution-NonCommercial-NoDerivatives 4.0 International License (CC BY-NC-ND)
Abstract
Background: To explore the perspectives of GPs, non-GP specialists, and allied health professionals on the role of primary care in diagnosing and managing chronic breathlessness, the barriers faced, and the resources needed to optimise care of patients with chronic breathlessness.
Methods: This was a qualitative study involving focus group discussions that included 35 GPs, non-GP specialists, and allied health professionals. Topics explored included: (1) views on the role of primary care in diagnosing and managing chronic breathlessness; (2) barriers to optimal assessment in primary care; and (3) facilitators to further optimise the care of patients with chronic breathlessness.
Results: All participants considered that primary care has a central role to play in the assessment and management of chronic breathlessness, but greater access to referral services, suitable funding structures, and upskilling on the use of diagnostic tests such as spirometry and electrocardiography are required for this to be realised. Both GPs and non-GP specialists described great potential for developing better linkages, including new ways of referral and online consultations, greater ease of referral to allied health services, even if conducted virtually, for patients with functional causes of breathlessness. Participants identified a need to develop integrated breathlessness clinics for patients referred by GPs, which would ensure patients receive optimal care in the shortest possible time frame.
Conclusions: GPs are crucial to achieving optimal care for breathless patients, especially given the multifactorial and multimorbid nature of breathlessness; however, there are significant gaps in services and resources at present that limit their ability to perform this role.
Keywords: allied health, assessment, breathlessness, general practitioner, integrated care, management, multimorbidity, patient-centred care, primary care.
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