Identifying the main long-term conditions contributing to the burden of chronic breathlessness: A scoping review

Introduction: Chronic breathlessness is a prevalent and distressing symptom associated with significant morbidity, healthcare utilisation and healthcare costs. However, the main long-term conditions contributing to the burden of chronic breathlessness to individuals and healthcare systems is unknown. A systematic scoping literature review was undertaken to identify the available literature to understand the potential long-term conditions contributing to the burden of chronic breathlessness. Methods: Relevant database searches (Embase and Medline) were conducted by a librarian in February and March 2023. Review articles and reference lists were also checked for relevant literature. Studies were selected where there was investigation into the causes of chronic breathlessness in different settings including general population, primary care, outpatients, acute hospital admissions, and palliative care settings. Results were summarised using a narrative synthesis. Results: Forty papers were included from 3848 studies identified. Twenty-six causes of chronic breathlessness were identified, sixteen of which were potentially important contributors to the burden of breathlessness to an individual or healthcare systems (Table 1). Six conditions were identified as having the greatest burden both to the individual (requiring palliative care services) and healthcare systems (hospital admission) (Table 1). Discussion: A systematic scoping review of the relevant literature has highlighted sixteen conditions contributing to the burden of chronic breathlessness. Five of the six conditions which contributed both to individual and healthcare system burden were respiratory. Healthcare policy should enable systems to prioritise healthcare for individuals with these conditions.