Multidisciplinary perspectives on the role of primary care in managing chronic breathlessness

Abstract

<b>Background and Aim:</b> To explore the perspectives of General Practitioners (GPs), multidisciplinary specialists, and allied health professionals on the role of primary care in diagnosing and managing patients with chronic breathlessness. <b>Methods:</b> Qualitative study involving focus group discussions with 35 health care providers: GPs (n=18), multidisciplinary specialists (n=8), and allied health professionals (n=9). Topics included: (1) the role of primary care in diagnosing and managing chronic breathlessness; (2) barriers to optimal assessment in primary care; and (3) facilitators to further optimize the care of patients with chronic breathlessness. <b>Results:</b> All participants considered that primary care has a pivotal role in the assessment and management of chronic breathlessness, but the multi-factorial etiology of this symptom makes diagnosis and management complex. Suggestions for improvement included greater access to referral services including online consultation, upskilling on the use of diagnostic tests such as spirometry and electrocardiography, greater ease of referral to allied health services, and more suitable Medicare rebate funding. There were differing views on GP use of chest CT-scan, brain-natriuretic-peptide, and echocardiograms. Participants identified a need to develop integrated breathlessness clinics for patients referred by GPs, which would ensure patients receive optimal care in the shortest possible timeframe. <b>Conclusions:</b> GPs are crucial to achieving optimal care of breathless patients, especially given the multifactorial and multimorbid nature of breathlessness.&nbsp;At present, there are significant gaps in services and resources which limit their ability to perform this role.