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- Page navigation anchor for Accepting age-related chronic symptoms with patient-centered careAccepting age-related chronic symptoms with patient-centered care
I have read, with great respect, the research titled “Diagnostic delays for breathlessness in primary care: a qualitative study to investigate current care and inform future pathways.”1 This research clarified the critical insights about the management of breathlessness for both physicians and patients. Breathlessness can be subjective, and the diagnosis can be challenging in chronic conditions. Subjective symptoms can be modified with patients’ previous experiences and socioeconomic status. This article shows that physicians try to be objective, so the conflict between physicians and patients can appear. The suggested approaches to breathlessness are the basis of family physicians and respect for patient-centered care for chronic breathlessness.
One of the vital things to approach chronic symptoms such as subjective breathlessness is patient-centered care for accepting aging, especially among older patients. Some older people may not accept the aging and persist in inquiring about other etiologies of their symptoms not related to aging even though ruling out critical diseases.2 For accepting age-related symptoms, patient-centered care is essential and respect their perceptions about their symptoms. The continual dialogue among older patients and healthcare professionals can mitigate the patients’ difficulty in accepting aging, which enables them to live with their chronic symptoms, such as breathlessness.3...
Competing Interests: None declared. - Page navigation anchor for Delays in diagnosing breathlessnessDelays in diagnosing breathlessness
I received my paper copy of the BJGP the same day as Dr Copperfield wrote in Pulse that guidelines and best practice get in the way of timely care.
I am aware of the wrong diagnosis is considered common but there are many obstacles that hinder care. Spirometry is a cause of obvious delay. Instead of a relatively quick ‘whilst you are here’ to give some idea of FEV1, FVC and PEF this now has to be done by someone with a gold standard ticket hence a delay. As more and more guidelines 'refer to a specialist nurse/or someone with a special interest in disease x', it is not surprising GPs are getting de skilled and people wait longer. As Dr Copperfield said the test advised for asthma (FeNO) don’t appear to exist in most areas
An example. At a junior parkrun the adult tail walker was surprisingly short of breath when the small children sprinted the last 100 metres. An informal non-medical chat with him revealed that he mentioned to his GP in Feb 2022 about his symptoms and was referred for lung function tests. He is still waiting. In my area many practices stopped spirometry (and ear syringing) during COVID and have not restarted.
Competing Interests: None declared.