Agreement with, and feasibility of, the emerging recommendations from the Living with Breathlessness study

Chronic obstructive pulmonary disease (COPD) carries a high symptom burden. Management of patients with advanced COPD should address patients' symptoms and care needs, optimise daily functioning and stabilise health status. The Living with Breathlessness study explored the question of how patients' and carers' needs change along the trajectory of advanced COPD and how guidelines should be amended to meet these changing needs. Six recommendations emerged from the study; we carried out an online survey of stakeholders who work with people living with advanced COPD in order to explore whether they agreed that the recommendations would improve care for people with COPD and what their opinions were on the ease of implementation of such recommendations in their place of work. Overall there was high agreement that all of the recommendations would improve care and support for people with advanced COPD; however, the survey also revealed caution around the ease of implementing some of these recommendations, as well as variation in responses among professional groups and settings. Concerns largely focused on the time and resources needed to implement the recommendations and, in particular, the resources needed to respond appropriately to any unmet needs identified through the more patient-focused and holistic analysis of patient and carer needs that these recommendations represent. The evidence from this survey suggests that there is a significant level of support for these recommendations among healthcare practitioners working with people with COPD. The vast majority of survey respondents agreed that each of the recommendations has the potential to improve the quality of life for COPD patients