BREATHE SMART- Breathlessness Rapid Evaluation And THErapy- Screening, Management And IntegRated Technology: Screening adults in Australian GP clinics

The BREATHE study consists of two components: BREATHE SMART (Breathlessness Rapid Evaluation And THErapy- Screening, Management And IntegRated Technology) and BREATHE CDSS (Breathlessness Rapid Evaluation And THErapy- Clinical Decision Support System). The details of the BREATHE CDSS study is registered seperately. The primary objective of BREATHE SMART is to develop a fully integrated system of patient self-screening for dyspnea in general practice. In the BREATHE SMART study we are working with Better Consult software, a product of HealthShare. BetterConsult is a pre-consultation tool that captures patients’ presenting symptoms, medications and other relevant clinical information and then translates the data into concise medical notes for review. Better Consult integrates with Best Practice, a leading primary care practice management software. Better Consult reads the practice electronic appointment book at the beginning of each day and sends an automated SMS prior to their scheduled GP appointment with a link to a specific self-screening survey. Each in scope patient (i.e. >= 18 years of age with a booked appointment with a GP) will be consented though the BetterConsult digital interface and initially asked to rate if they have any difficulty with breathing using the validated mMRC scale. If they rate this answer as “0” (no dyspnea) then they will not progress any further. For all other patients, dyspnea will be further assessed using the Dyspnea-12 (D-12) score- a questionnaire that quantifies physical/affective aspects of dyspnea and queried about the length of time they have been experiencing breathlessness. The screening procedure will take 5-10 minutes to complete, and patients will be invited to participate at each GP appointment they attend through the study period. These screening results will be imported to the patient’s electronic medical record. When the GP opens the patient's electronic medical record the GP will be prompted to review these results and can discuss this with the patient during their appointment or at a subsequent visit. Further investigations and management will be at the GP's discretion. GPs will be trained in use of the CDSS and in interpretation of the various scales. GP usage of the CDSS will be able to be tracked by the performance metrics of the software. The patient self-screening intervention will run for 12 months in each practice.