Background Breathlessness is a common symptom experienced by people with advanced respiratory disease (Spathis, Booth, Moffat, et al. NPJ Prim Care Respir Med. 2017;27(1):27) and cancer (Hui, Maddocks, Johnson, et al. ESMO Open. 2020; 5(6): e001038). Locally, there is little support for patients who are experiencing severe breathlessness due to progressive or life-limiting illness.

Aims To develop and implement a palliative care out-patient based programme to support and educate patients who experience breathlessness due to advanced disease.

Method Identification of need was confirmed through local audit, discussion with acute services and review of the hospice community caseload. Two Clinical Nurse Specialists (CNSs) and two Physiotherapists attended the Cambridge Breathlessness Intervention Service: Breathing, Thinking, Functioning model (Spathis, Booth, Moffat, et al. NPJ Prim Care Respir Med. 2017;27(1):27) study day which ensured a standardised knowledge base within the team. A six session programme was designed, each weekly two hour ‘Breathe Well’ session included a discussion topic related to breathlessness, seated exercise and relaxation as part of a holistic approach. A maximum of ten patients per group enabled adequate peer support with appropriate risk management. At the end of each group, patient evaluation data was collected.

Results Between February and December 2023, 30 patients completed the programme across the four groups that were held. In total 37 patients accepted group invitations, six patients died prior to or during their allotted group dates and one was too fatigued to continue. Evaluation data was collected using a satisfaction survey and outcome measures relating to feelings of control and confidence with managing breathlessness. Goals were also reviewed using the Goal Attainment Scaling (GAS-light) score (Kiresuk, Sherman. Community Ment Health J. 1968; 4(6):443–453; Turner-Stokes. Clin Rehabil. 2009; 23(4): 362–70). Peer support was positively evaluated and improvements were recorded in breathlessness control, mood and wellbeing in nearly all participants.

Conclusion This project highlighted the beneficial effects of a holistic MDT programme and peer support within breathlessness management in palliative care. Evaluation of the programme is ongoing to ensure continued cost effectiveness and positive outcomes.