Managing breathlessness for people with advanced respiratory disease

Chronic respiratory diseases encompass diverse, nonmalignant respiratory diseases that share common symptoms, including cough, fatigue and chronic breathlessness. Chronic breathlessness imposes a significant burden on patients and is challenging for clinicians to manage effectively. Effective management of breathlessness requires a stepwise approach that involves 1) recognition and measurement of the symptom; 2) identification and optimal disease-directed management of any underlying conditions; and 3) consideration and trial of nonpharmacological management approaches. Currently, there is a dearth of safe and effective pharmacological approaches. Models of care for managing breathlessness vary broadly. While integrated specialist respiratory services are effective at improving breathlessness management, they are limited in capacity. Upskilling primary and community care can expand the reach and accessibility of breathlessness management. Ultimately, fostering self-management skills to empower people with breathlessness to better control their daily symptoms is core to improving efficiency within breathlessness care.