Digital support for chronic dyspnoea management in primary care: protocol for the BREATHE (Breathlessness Rapid Evaluation and Therapy) cluster randomised controlled trial

作者：Allison Martin, Anthony Paulo Sunjaya, Katrina Giskes, Zoe McKeough, Charlotte Hespe, C Arnott, Laurent Billot, Anna Campain, Caroline Polak Scowcroft, E. Atkins, Stephen Jan, Hayley A Scott, Ai-Vee Chua, Christine Jenkins · 发表于：BMJ Open · 年份：2025 · DOI：10.1136/bmjopen-2025-108255 · 被引用次数：3 · 研究领域：Respiratory and Cough-Related Research、Chronic Obstructive Pulmonary Disease (COPD) Research、Dysphagia Assessment and Management

INTRODUCTION: Chronic dyspnoea is a prevalent symptom, and primary care is ideally placed to identify and manage it. However, chronic dyspnoea is under-reported by patients and can be a diagnostic dilemma for practitioners. A fully automated system of patient screening, coupled with a clinical decision support system (CDSS) that uses a validated and evidence-based dyspnoea algorithm, may improve detection, diagnosis and management of the condition. There is currently no CDSS validated for chronic dyspnoea diagnosis and management in primary care in Australia. The objectives of this study are to assess the clinical impact of a CDSS for chronic dyspnoea in primary care. We hypothesise that the use of the CDSS will lead to a clinically significant improvement in patient-reported dyspnoea scores, reduced time to diagnosis and healthcare costs at 12 months compared with standard care. METHODS AND ANALYSIS: CDSS-guided management. The CDSS includes an algorithm derived from a robust data and clinical knowledge model and incorporates evidence-based recommendations for the assessment and management of chronic dyspnoea. It is integrated into general practice medical software systems, fitting in the workflow of general practitioners (GPs). Eligible patients will be ≥18 years old and will have previously consented to receive SMS communication from their practice. In-scope patients will receive an automated text message prior to their GP appointment and will be screened for chronic dyspn...