Patient perspectives on how to optimise benefits from a breathlessness service for people with COPD

This study aimed to inform understanding of how to optimise patient-perceived benefits from a breathlessness service designed for patients with moderate to very severe chronic obstructive pulmonary disease (COPD). The Westmead Breathlessness Service (WBS) trains patients to self-manage over an 8-week programme, with multidisciplinary input and home visits. A qualitative approach was taken, using semi-structured telephone interviews. Each transcript was globally rated as suggesting 'significant', 'some' or 'no' impact from WBS, and thematic analysis used an integrative approach. Forty-one consecutive participants were interviewed to reach 'information power'. Eighteen (44%) participants reported 'significant' impact, 17 (41%) 'some' impact, and two (5%) 'no' impact. Improvements to breathlessness were usually in the affective and impact dimensions but, more uncommonly, also sensory-perceptual. Participants who benefited in self-esteem, confidence and motivation attributed this to one-to-one multidisciplinary coaching and home visits. Further research should test whether including/excluding more intensive programme elements based on individual need might improve cost-effectiveness.