“You can do it yourself and you can do it at your convenience”: internet accessibility and willingness of people with chronic breathlessness to use an internet-based breathlessness self-management intervention during the COVID-19 pandemic

Charles C. Reilly; Katherine Bristowe; Anna Roach; Matthew Maddocks; Irene J. Higginson

doi:10.1183/23120541.00557-2021

Charles C. Reilly, Katherine Bristowe, Anna Roach, Matthew Maddocks, Irene J. Higginson

Original language	English
Article number	00557-2021
Journal	ERJ Open Research
Volume	8
Issue number	1
Early online date	21 Feb 2022
DOIs	https://doi.org/10.1183/23120541.00557-2021
Accepted/In press	23 Dec 2021
E-pub ahead of print	21 Feb 2022
Additional links	Link to publication in Scopus

Funding Information: Conflict of interest: An NIHR Clinical Lectureship (ICA-CL-2018-04-ST2-001) supports C.C. Reilly, which funds all aspects of this research. In addition, and unrelated to the present research, they declare funding to their institution from “King’s Together: Multi and Interdisciplinary research scheme” (GBP 19 000) and from Royal Brompton Hospital–King’s Health Partnership Transformation (GBP 75000). K. Bristowe declares research grants to their institution from the National Institute for Health Research, Medical Research Council, Health Education England, European Commission and Marie Curie, in the 36 months prior to manuscript submission. A. Roach declares no competing interests. M. Maddocks declares a National Institute for Health Research (NIHR) Career Development Fellowship (CDF-2017–10-009), and an infrastructure grant from the NIHR Applied Research Collaboration South London (NIHR ARC South London) at King’s College Hospital NHS Foundation Trust, in the 36 months prior to manuscript submission. I.J. Higginson declares research grants from the National Institute for Health Research, UK Research & Innovation, Cicely Saunders International and Marie Curie, in the 36 months prior to manuscript submission. Funding Information: Support statement: A National Institute for Health Research (NIHR) Clinical Lectureship (ICA-CL-2018–04-ST2–001) supports C.C. Reilly. M. Maddocks is supported by an NIHR Career Development Fellowship (CDF-2017–10– 009). M. Maddocks and I.J. Higginson are supported by the NIHR Applied Research Collaboration South London. This publication presents independent research funded by the NIHR. The views expressed in this publication are those of the authors, and not necessarily those of the National Health Service, NIHR or the Dept of Health and Social Care. Funding information for this article has been deposited with the Crossref Funder Registry. Publisher Copyright: © 2022, European Respiratory Society. All rights reserved.

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Introduction The burden of chronic breathlessness on individuals, family, society and health systems is significant, and set to increase exponentially with population ageing, complex multimorbidity and coronavirus disease 2019 (COVID-19)-related disability. Breathlessness support services are effective; however, reach and access are limited. Delivering online breathlessness interventions may build capacity and resilience within health systems to tackle chronic breathlessness through supported self-management. The aim of this study was to explore accessibility and willingness of patients with chronic breathlessness to use an internet-based breathlessness self-management intervention (SELF-BREATHE). Methods Semi-structured telephone interviews were conducted with adults living with advanced malignant and non-malignant disease and chronic breathlessness (July to November 2020). Interviews were analysed using conventional and summative content analysis. Results 25 patients (COPD: n=13; lung cancer: n=8; interstitial lung disease (ILD): n=3; bronchiectasis: n=1) were interviewed: 17 male, median (range) age 70 (47–86) years and Medical Research Council dyspnoea score 3 (2–5). 21 patients had internet access. Participants described greater use, acceptance and normalisation of the internet since the advent of the COVID-19 pandemic. They described multifaceted internet use: functional, self-investment (improving health and wellbeing) and social. The concept of SELF-BREATHE was highly valued, and most participants with internet access were willing to use it. In addition to technical limitations, personal choice and perceived value of the internet were important factors that underpinned readiness to use online resources. Conclusion These findings suggest that patients living with chronic breathlessness that have access to the internet would have the potential to benefit from the online SELF-BREATHE intervention, if given the opportunity.

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