Lung health: Diagnosing causes of breathlessness early means better outcomes

The British Lung Foundation has launched a new campaign to raise awareness of breathlessness. Dr Noel Baxter explains how GPs can best respond to patients seeking advice.

The British Lung Foundation is launching a simple but important 'Listen to your Lungs' campaign message: If you’re breathless doing everyday activities, taking longer to do things or even avoiding doing things because you get out of breath, it’s time to see your doctor.

Our surgeries may find more patients coming for further investigation. This is a good thing as earlier diagnosis and treatment means better outcomes.

Increasing awareness is important

Increased awareness of breathlessness among patients is important - it encourages early diagnosis of respiratory-related diseases. As GPs, we must understand the best way to respond.

I’ve seen distressed people with long-term disabling breathlessness being sent from cardiology to respiratory and back, in the past. This isn’t good enough. We now need our specialists to manage the symptom of breathlessness with appropriate therapies, psychology and palliative care colleagues.

Our response to the presentation of breathlessness should be measured, with considerations around the need for specialist organ system support. There are general clinical care pathways for treating the more common conditions such as COPD, asthma and heart failure and these should be used as a guide.

Holistic approaches

Sometimes single disease guidelines might be limiting and a more holistic approach is called for. For example, breathlessness could initially be caused by mild COPD, but what are the spin-off impacts or associations on the patient: depression, obesity, lack of fitness?

These might be the real issues that need addressing in the short-term. The value of general practice is in recognising what needs to be done and working with people to make a plan, rather than slavishly following a single guideline as might happen with a single disease specialist.

Depending on the cause, and how advanced the condition is, there are a range of responses open to us:

  • Prescribe physical activity, cardiac and pulmonary rehabilitation (PR)
  • Promote and provide an annual flu vaccination as a core part of the treatment plans
  • Help patients live with breathlessness by ensuring they see a symptoms expert
  • Support patients with treatments recommended by the experts
  • Treat anxiety and depression. 

Dealing with anxiety and depression can create new and unexpected social opportunities. Do you have a local patient choir? We know singing reduces anxiety, lengthens the out-breath, and reduces sensitivity to breathlessness. If you don’t have such a group, lobby your joint commissioners to get one set-up.

The British Lung Foundation already runs a number of singing groups – you can find further details here.

If we do see more patients as a result of this campaign, we should be prepared, understand the range of conditions indicated by breathlessness and the options we have in ensuring the most appropriate treatment and support.

  • Dr Noel Baxter is a GP and honorary medical adviser for the British Lung Foundation

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