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Publications

Journal Article Epublish

PubMed: 42311870 DOI: 10.1183/23120541.00954-2025

BREATHE: an educational approach for optimising the management of chronic respiratory diseases in primary care.

ERJ Open Res 12(3)

Authors: Natasha Smallwood, Rebecca Disler, Amy Pascoe, Lena Ly, Andrew Donald, Kerry Hancock, Christian Osadnik, Yet Hong Khor, Jo-Anne Manski-Nankervis, Anna Spathis, Jennifer Philip, Lena Sanci

Affiliations

  • Respiratory Research @ Alfred, School of Translational Medicine, Monash University, Melbourne, VIC, Australia.
  • Department of Respiratory and Sleep Medicine, Alfred Health, VIC, Australia.
  • These authors contributed equally.
  • University of Melbourne, Melbourne, VIC, Australia.
  • Department of General Practice and Primary Care, Faculty of Medicine, Dentistry and Health Sciences, University of Melbourne, Parkville, VIC, Australia.
  • Allergy and Lung Health Unit, Melbourne School of Population and Global Health, The University of Melbourne, Parkville, VIC, Australia.
  • Department of Physiotherapy, Monash University, Melbourne, VIC, Australia.
  • Respiratory Research @ Alfred, School of Translational Medicine, Monash University, Melbourne, VIC, Australia. Department of Respiratory and Sleep Medicine, Austin Health, Heidelberg, VIC, Australia. Institute for Breathing and Sleep, Heidelberg, VIC, Australia.
  • Primary Care and Family Medicine, Lee Kong Chian School of Medicine, Nanyang Technological University, Singapore.
  • Department of Public Health and Primary Care, University of Cambridge, Cambridge, UK.
  • St Vincent's Hospital, Melbourne, VIC, Australia.

Abstract

INTRODUCTION AND AIM

Optimisation of underlying chronic respiratory disease (CRD) is a necessary first step to addressing breathlessness. We aimed to develop and evaluate a disease-agnostic education package and mnemonic to support primary care providers to recognise breathlessness and facilitate optimisation of underlying CRD.

METHODS

A blended education package comprising one live webinar, three self-paced online courses, two podcasts and five case studies was developed by a working group of general practitioners (GPs), respiratory clinicians and researchers and adapted into a practical mnemonic (the BREATHE clinical approach). Content was validated against a systematic state-of-the-art review of international and national guidelines. Semi-structured interviews with GPs, general practice nurses and a practice manager were conducted to evaluate the educational content and design. Interviews were transcribed and analysed thematically with inductive coding.

RESULTS

Seven disease-agnostic recommendations were developed and validated against 33 clinical practice documents: Breathlessness (measure severity); Respiratory illness (confirm diagnosis); Extra illnesses (consider other causes of breathlessness); Adherence (check medication use and technique); Tobacco (discuss smoking cessation); Help (consider referral to specialist services); Exercise (consider pulmonary rehabilitation). 13 interviews were conducted (eight GPs; four nurses; one practice manager); this showed the BREATHE educational package and clinical approach to be acceptable. Time constraints were frequently cited as a barrier to education engagement, with flexible education preferred. Respondents described the BREATHE clinical approach as a comprehensive tool that would enable clinicians to "remember the specifics", while highlighting the need for multiple consultations to address all elements of care.

CONCLUSION

The BREATHE clinical approach and education package were favourably received as useful tools to support primary care providers to optimise treatment for people with CRD.

MeSH

Nurses, Dyspnea, Education