Targeting exertional breathlessness to improve physical activity: the role of primary care

Abstract

Primary care physicians (PCPs) play a crucial role in the diagnosis and management of chronic obstructive pulmonary disease (COPD). By working together with patients to target exertional breathlessness and increase physical activity, PCPs have an important role to play, early in the disease course, in improving patient outcomes in both the short and long term. In this article, we consider how physical activity affects disease progression from the PCP perspective. We discuss the role of pharmacological therapy, the importance of an holistic approach and the role of PCPs in assessing and promoting physical activity. The complexity and heterogeneity of COPD make it a challenging disease to treat. Patients’ avoidance of activity, and subsequent decline in capacity to perform it, further impacts the management of the disease. Improving patient tolerance of physical activity, increasing participation in daily activities and helping patients to remain active are clear goals of COPD management. These may require an holistic approach to management, including pulmonary rehabilitation and psychological programmes in parallel with bronchodilation therapy, in order to address both physiological and behavioural factors. PCPs have an important role to optimise therapy, set goals and communicate the importance of maintaining physical activity to their patients. In addition, optimal treatment that addresses activity-related breathlessness can help prevent the downward spiral of inactivity and get patients moving again, to improve their overall health and long-term prognosis.

Motivating factors for physical activity participation among individuals with chronic obstructive pulmonary disease: A qualitative study applying the motivation, opportunity, and ability model

“…Due to constraints like time, treatment priorities, and a lack of expertise, they often prefer physiotherapists to provide more comprehensive assessments and recommendations [ 39 ]. Extensive research demonstrates the significant roles of primary care physicians [ 40 ], nurses [ 41 ], and occupational therapists [ 42 ] in providing respiratory care services, setting goals, and delivering self-management education, particularly through the provision of remote healthcare services based on multidisciplinary teamwork, which prioritizes the needs of various stakeholders [ 43 ]. Additionally, patients find remote media training interventions meaningful, aiding in their adherence to basic activities in daily life [ 44 ].…”

Airflow rates and breathlessness recovery from submaximal exercise in healthy adults: prospective, randomised, cross-over study

“…In those living with medical conditions -a group less likely to achieve recommended physical activity levels (6) due to avoidance of exertion-related breathlessness (7) -cool facial airflow from a handheld fan (fan) reduces breathlessness severity (8)(9), improves exercise capacity (10) and hastens recovery from exercise (11)(12). The mechanisms for these effects are not completely understood.…”