Johnston Kylie N, Young Mary, Kay Debra, Williams Marie T
Implementation and Clinical Translation in Health (IIMPACT), Allied Health and Human Performance, University of South Australia, Adelaide 5000, Australia.
Department of Thoracic Medicine, Heart and Lung Service, Central Adelaide Local Health Network, Adelaide 5000, Australia.
J Clin Med. 2025 Jun 1;14(11):3894. doi: 10.3390/jcm14113894.
Persistent breathlessness impacts people living with advanced chronic obstructive pulmonary disease (COPD) and carers. Accessible services are limited. This translational pilot study evaluated the feasibility, impacts on patient and carer-reported outcomes, and hospital use of a home-based breathlessness intervention service (BLIS). : People with stable COPD, ≥1 COPD-related hospital admissions in the previous year, and persistent breathlessness participated in a pre-post study. The BLIS program involved home visits/phone contacts by a nurse/physiotherapist (average 8 contacts, 7 weeks). Uptake, retention, and fidelity were recorded prospectively, and participant experience was explored (post-program interviews). Breathing discomfort (Multidimensional Dyspnea Profile A1 scale), threat (Brief Illness Perception Questionnaire), and carer stress/strain (Zarit Burden Interview) were compared pre- and post-program (week 9, 3 and 6 months) using mean difference and 95% confidence intervals (CIs). Hospital use for COPD-related causes in 12 months before/after participation was reported. : A total of 16/19 eligible people agreed to participate, and 15/16 completed the program. In participants with COPD (73 [9] years, FEV1%pred 42% [15], mean [SD]; a median of 3 COPD-related hospital admissions in the previous year) and carers ( = 6), BLIS was highly (in 95%) acceptable. Compared to pre-program, breathing discomfort was reduced in week 9 and 6 months; breathlessness threat was reduced in week 9 and 3 months; and carer burden was reduced at 6 months. Compared to the 12 months prior, hospital admissions decreased in the 12 months post-program. : Translation of this service to the local setting was feasible, with high program uptake and retention. Post-program improvements in key patient- and carer-reported outcomes and a reduction in public hospital admissions support the implementation of the BLIS program for this cohort in this setting.
持续性呼吸困难影响晚期慢性阻塞性肺疾病（COPD）患者及其照护者。可获得的服务有限。这项转化性试点研究评估了一项基于家庭的呼吸困难干预服务（BLIS）的可行性、对患者和照护者报告结局的影响以及医院使用情况。：患有稳定期COPD、前一年有≥1次与COPD相关的住院治疗且有持续性呼吸困难的患者参与了一项前后对照研究。BLIS项目包括护士/物理治疗师进行家访/电话联系（平均8次联系，为期7周）。前瞻性记录接受情况、留存率和保真度，并探索参与者的体验（项目结束后访谈）。使用平均差和95%置信区间（CI）比较项目前后（第9周、3个月和6个月）的呼吸不适（多维呼吸困难量表A1）、威胁感（简短疾病认知问卷）和照护者压力/负担（ Zarit负担访谈）。报告参与前后12个月内因COPD相关原因的住院情况。：共有16/19名符合条件的人同意参与，15/16人完成了该项目。在COPD患者（73[9]岁，FEV1%预计值42%[15]，均值[标准差]；前一年与COPD相关的住院治疗中位数为3次）和照护者（=6）中，BLIS的接受度很高（95%）。与项目前相比，第9周和6个月时呼吸不适减轻；第9周和3个月时呼吸困难威胁减轻；第
