TY - JOUR T1 - Intractable breathlessness in COPD – A suitable case for palliation? JF - European Respiratory Journal JO - Eur Respir J VL - 38 IS - Suppl 55 SP - p687 AU - Patrick White AU - Sara Booth AU - Sofia Georgopoulou AU - Wai Yee James AU - Scott Murray AU - John Moxham AU - Hilary Pinnock AU - Paul Seed AU - Cathy Shipman AU - Irene Higginson AU - Hannah Thornton AU - Helen Booth Y1 - 2011/09/01 UR - http://erj.ersjournals.com/content/38/Suppl_55/p687.abstract N2 - Introduction: Breathlessness is the major symptom of concern for people with advanced COPD. Intractable breathlessness may be described as “sustained severe breathlessness in patients who have not obtained relief from conventional treatment”. This study set out to define the prevalence of intractable breathlessness in COPD and potential for its palliation.Method: COPD patient records in south London practices were searched for ≥2 of: FEV1 ≤30% predicted, hospital admissions/exacerbations needing oral steroids, long term O2, and cor pulmonale. Participants were interviewed at home. Breathlessness was assessed using MRC Dyspnoea, mBorg, NRS, Dypsnoea-12 and Chronic Respiratory Questionnaire. Intractable breathlessness was defined using a combination of FEV1% predicted, CRQ-Dyspnoea, Dyspnoea-12 and the desire for more help. Treatment optimisation was offered where appropriate before reassessment of breathlessness.Results: 5102 patients were identified in 72 practices, 2163 had spirometry-confirmed COPD. 260 (5%) were eligible and 146 (56%) took part. 65% reported breathlessness as their most important problem, 69% reported breathlessness everyday and 59% reported needing more help for breathlessness. 69% scored 4-5 on MRC Dyspnoea Scale. 63 (43%) were on sub-optimal treatment, 97% of whom received optimisation. Improvements in breathlessness weren't observed at re-assessment. 29 (20%) participants had intractable breathlessness; an estimated 2% of patients with confirmed COPD in the study population.Conclusion: Intractable breathlessness affects around 1 in 50 COPD patients on practice registers. Increased recognition of this problem and provision of specialist palliative services for these patients is a priority. ER -