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P-88 Internet-based cognitive behavioural therapy for breathlessness in a palliative care setting
  1. Erzsi Nemeth and
  2. Sharon Chadwick
  1. Hospice of St Francis, Berkhamsted, UK


Introduction Chronic refractory breathlessness has long been recognised as a major cause of human suffering and health care expenditure. Breathless episodes frequently trigger anxiety and distress in both patient and carer, often leading to admission to hospital, or increased calls to health care professionals. Non-pharmacological management of breathlessness plays an important role in reducing suffering; however, many patients find it difficult to access this care as they are often symptomatically isolated within their home.

The prevalence of panic disorder in those with chronic breathlessness is significantly greater than that of the overall population, with a 10 times greater prevalence in those with Chronic Obstructive Pulmonary Disease (COPD).

Cognitive Behavioural Therapy (CBT) is an established therapy for anxiety disorders, and is effective in breathlessness. Internet-based CBT (iCBT) is as effective as traditional CBT when it comes to anxiety, and is accessible for patients in their own home. Currently there is no internet provision using iCBT for the management of breathlessness.

Aim To set up and pilot an innovative internet site, that is interactive and highlights the non-pharmacological management of breathlessness. In particular, there will be an iCBT course specifically for managing anxiety, related to breathlessness.

Method Initial phase The Internet Support Team will create a new password protected internet site embedded in the current hospice site. The site will include both written and video education material regarding the non-pharmacological management of breathlessness. Anxiety and depression scores (9) will be completed; with email alerts to the service provider if scores are significant for each. Patients can then access interactive breathlessness tailored iCBT, with weekly feedback from a qualified CBT therapist.

Future work The scope for future work for this innovative interactive website is immense. In particular, the site can be extended to include carers, who are often also isolated and find it difficult to leave the home.

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