{
  "abstract": "Introduction The recognition of breathlessness in clinical practice appears suboptimal, despite its prevalence and impact. This study aimed to explore the content of clinical conversations about breathlessness and patients’ level of self-reported openness when discussing their breathlessness.Methods A cross-sectional, online survey of Australian adults (≥18 years) stratified to the 2016 National Census for age, sex, state/territory of residence and rurality. Assessments based on self-report included demographics, breathlessness (modified Medical Research Council (mMRC) breathlessness scale), breathlessness duration (months/years) and underlying condition (multiple-choice question), breathlessness-related topics discussed (multiple-choice question) and patients’ openness about breathlessness (multiple-choice question).Results Of 4245 respondents with mMRC ≥1 2311 (54%) reported discussing breathlessness with their clinician. The majority were patient-initiated conversations (94%; n=2179) where the proportion discussing >1 topic was higher with each mMRC level (34% mMRC1; 40% mMRC2; 50% mMRC3-4) in contrast with clinician-initiated conversations (32% mMRC1; 5% mMRC2; 22% mMRC3-4).Patient-initiated conversations prioritised discussing the topics ‘how the person feels’ (mMRC1) and ‘breathlessness’ impacts’ (mMRC2-4); clinician-initiated consultations prioritised ‘breathlessness’ impacts’ (mMRC1-2) and ‘how the person feels’ and ‘doubts/fears’ (mMRC3-4).Compared with clinician-initiated conversations, patient-initiated ones had a higher proportion of respondents reporting being completely open (73% vs 56%, mMRC1; 58% vs 7%, mMRC2; 75% vs 22%, mMRC3-4). Increasing openness was associated with increasing age, gender (women), smoking status (non-smokers) and underlying condition (lung disease).Conclusions Many patients are willing to discuss multiple aspects of their breathlessness but may not disclose the full extent of the symptom’s presence or impacts.",
  "authors": [
    {
      "affiliations": [
        "Flinders University College of Medicine and Public Health, Adelaide, South Australia, Australia",
        "University of Technology Sydney, Sydney, New South Wales, Australia"
      ],
      "name": "Slavica Kochovska"
    },
    {
      "affiliations": [
        "University of Technology Sydney, Sydney, New South Wales, Australia"
      ],
      "name": "Sungwon Chang"
    },
    {
      "affiliations": [
        "Faculty of Science, Medicine and Health, University of Wollongong, Wollongong, New South Wales, Australia"
      ],
      "name": "Diana Ferreira"
    },
    {
      "affiliations": [
        "Faculty of Science, Medicine and Health, University of Wollongong, Wollongong, New South Wales, Australia"
      ],
      "name": "Vanessa Brunelli"
    },
    {
      "affiliations": [
        "University of Technology Sydney, Sydney, New South Wales, Australia"
      ],
      "name": "Tim Luckett"
    },
    {
      "affiliations": [
        "Department of Respiratory Medicine, Concord Repatriation General Hospital, Sydney, New South Wales, Australia"
      ],
      "name": "Lucy Morgan"
    },
    {
      "affiliations": [
        "Faculty of Science, Medicine and Health, University of Wollongong, Wollongong, New South Wales, Australia"
      ],
      "name": "Jessica Macdonald"
    },
    {
      "affiliations": [
        "Adelaide Institute for Sleep Health, Flinders University, Adelaide, South Australia, Australia"
      ],
      "name": "Thomas Altree"
    },
    {
      "affiliations": [
        "Wolfson Palliative Care Research centre, Hull York Medical School, The University of Hull, Hull, UK"
      ],
      "name": "Miriam J Johnson"
    },
    {
      "affiliations": [
        "Faculty of Medicine, Department of Clinical Sciences Lund, Respiratory Medicine, Allergology and Palliative Medicine, Lund University, Lund, Sweden"
      ],
      "name": "Magnus Ekström"
    },
    {
      "affiliations": [
        "Flinders University College of Medicine and Public Health, Adelaide, South Australia, Australia"
      ],
      "name": "David Currow"
    }
  ],
  "title": "Don’t ask, don’t tell (DADT): under-recognition of breathlessness in clinical care—a national survey",
  "uid": "a2149df1-59c6-5db0-bbc3-f1ef51f3dda2"
}