Implications for practice
obesity, breathlessness, anxiety
OBESITY
This study found that there are challenges associated with reaching a meaningful diagnosis for patients with breathlessness, but that recognition and validation of the symptom of breathlessness is an important first step. Time is a constant pressure in GP consultations; however, time spent early on listening to patients’ concerns about how breathlessness affects them may improve the overall patient experience.The clinician’s communication style has a profound effect on the patient, and training around advanced communication skills, opportunistic behaviour change, and motivational interviewing have been shown to have some benefit.It is important for clinicians to consider breathlessness as a therapeutic target, as well as an important indicator of underlying illness.This study indicates that clinicians value specialist support in instances where a diagnosis is less straightforward. Understanding the most effective way to communicate the key messages to patients when the diagnosis for breathlessness is deconditioning, obesity, or anxiety, or where other conditions have been excluded, alongside a personalised symptom-based management plan, could also be of benefit.A complex intervention is needed to support patient and clinician recognition of breathlessness, early symptom-based investigation that allows for the detection of multiple causes, and support for clinicians to be confident with delivering less disease-specific diagnostic labels such as deconditioning.The authors would like to thank the patient and clinician participants for taking part in the interviews, and the GP practices involved in the wider Breathe DEEP study. The authors also give thanks to the public and patient involvement members and external trial steering committee members for their assistance in reviewing the study as a whole, and to Jill Clanchy from the clinical trials unit at the University of Leicester for her support with the wider study.