Primary Breathe AUS: A primary care technology-enabled intervention to improve symptom self-management for people with chronic respiratory illness

Chronic breathlessness is one of the most common and distressing symptoms experienced by people with chronic respiratory disease (CRD), with profound impacts on patients and carers, and generating significant unscheduled healthcare use. Yet symptom-directed breathlessness management is challenging. Self-management approaches are effective, but under-utilised, as they require health professional expertise and patient engagement. This research program addresses the need to improve symptom-directed care for people with chronic breathlessness and CRD. We hypothesise that people with chronic breathlessness and CRD will benefit from a technologyenabled, self-management intervention delivered by primary care clinicians. We propose a 5-year program with 3 work streams (WS) to develop and clinically-validate a technology-enabled, primary care intervention. WS1 includes 3 studies developing technological resources: 1) optimisation of existing dyspnoea website by patients, carers, and clinicians, 2) adaptation of Primary Breathe App licensed from UK collaborators for Australian consumers, and 3) design of online breathlessness management training packages for primary care clinicians. WS2 includes 2 studies: 1) co-design of Primary Breathe AUS self-management intervention with patients, carers, and clinicians, and 2)
development of primary care electronic medical records module to facilitate identification of patients with chronic breathlessness and CRD for the clinical trial. Drawing on the outputs from WS1 and WS2, WS3 includes 3 studies:1) a Phase 2/3 randomised controlled trial of the Primary Breathe AUS technology-enabled self-management intervention to determine efficacy with main outcome being mastery of breathlessness, 2) evaluation of consumer telehealth literacy to determine accessibility of and barriers to the intervention approach, and 3) process evaluation with patients, carers, and clinicians to determine facilitators and barriers to broader implementation.