Impress publications

As part of the suite of resources for improving the assessment and treatment of the adult population bothered by long term breathlessness, these are the Breathlessness IMPRESS Tips (BITs) for commissioners. They include a number of examples of approaches and services that are being tested around the country, as well as some draft aims, objectives and criteria for breathlessness services that could be used for local discussion and negotation.  The blog Impressions 31 introduces the project, lists the working party, and provides links to the other elements including BITS for clinicians, patients and researchers and an algorithm for clinicians.     NOTE: this is an updated edition with activated hyperlinks and a new example on page 6 from Outer North West London Integrated Care Pilot for COPD using 40 minute care planning consultations.

These Breathlessness IMPRESS Tips (BITs) are one of a set of four BITs based on an IMPRESS programme to develop guidance for clinicians including an assessment and treatment interactive algorithm, commissioners, patients and researchers about how to improve services for their breathless population. See the Introduction and Methodology, Scope and Definitions for background information and references and the Prevalence Modelling that describes the size of the problem of long term breathlessness in adults.

All material can be freely accessed from here.

These BITs for researchers summarise the questions that need answering about the assessment and management of adults with long term breathlessness and highlight areas of uncertainty or lack of knowledge we found when researching this work. We encourage the Academic Health Science Networks in England, and other research networks to address them.  

As background to the IMPRESS Breathlessness IMPRESS Tips (BITs) for clinicians, patients, commissioners and researchers and the breathlessness algorithm this paper describes our methodology, definitions and also contains a summary of our literature review summarising for each main contributor to long term breathlessness (COPD, heart failure, anxiety, obesity and anaemia) what we know about the proportion of people with that condition who are breathless and what proportion of the breathless population has each of these conditions.  It also describes what is known about multimorbidity and breathlessness.   From the IMPRESS breathlessness working party and the Department of Management, London School of Economics and Political Science.  For working party details see here

There is surprisingly little epidemiological data on the prevalence of breathlessness in the UK.  However, from those that exist, we estimate that up to 10% of the general adult population is bothered by long term breathlessness and as many as 30% of older people.  This summary of a major literature review by the Department of Management at the London School of Economics and Political Scence, supported by the Health Foundation, and working with the IMPRESS Breathlessness Working Party provides commissioners and clinicians with an overview of the literature and the summary findings.  It is useful background to the  IMPRESS Breathlessness suite of resources including the interactive algorithm, and Breathlessness IMPRESS Tips (BITs) for clinicians, patients and commissioners.  It is accompanied by detailed prevalence modelling for each condition.  For more information go to

http://www.impressresp.com/index.php?option=com_content&view=article&id=172:impressions-31-breathlessness&catid=11:impressions&Itemid=3

This fully referenced paper summarises the Breathlessness IMPRESS Tips (BITs) for all clinicians who assess and care for adults with long term breathlessness.  It also provides accompanying notes to the IMPRESS breathlessness interactive algorithm (Dec 2013).  It can also be used by commissioners to work with local clinicians and patients to discuss how to integrate assessment and care for the many local people who are likely to have more than one condition causing their breathlessness such as COPD, heart failure, asthma, anxiety, obesity and anaemia.  The appendices offer examples of easy-to-use validated assessment tools.   It was produced by a cross-specialty and cross-profession IMPRESS working party.  For a full list go to http://www.impressresp.com/index.php?option=com_content&view=article&id=172:impressions-31-breathlessness&catid=11:impressions&Itemid=3

A new algorithm from a multi-professional, multi-specialty IMPRESS Breathlessness Working Party supported by the Department of Management at the London School of Economics and Political Science on the assessment and management of long term/chronic breathlessness combining guidance on asthma, anxiety, COPD, heart failure, obesity and anaemia for clinicians working in general practice and community and hospital settings.  The design has been supported by a grant from the Health Foundation.

Breathlessness IMPRESS Tips (BITs) for patients are one of a set of four BITs based on an IMPRESS programme to develop guidance for clinicians, commissioners, patients and researchers about how to improve the care for people bothered by breathlessness.  This offers practical guidance to patients including information about COPD and heart failure, managing anxiety and offering a range of detailed evidence-based coping tips.  It can be offered to patients by clinicians.

This paper from the IMPRESS Working Party on Breathlessness introduces our approach to developing a suite of papers including a breathlessness algorithm, Breathlessness IMPRESS Tips for clinicians, patients, commissioners and researchers as well as prevalence modelling for breathlessness in anxiety, COPD, heart failure, obesity and anaemia, working with the Department of Management at the London School of Economics and Political Science supported by the Health Foundation.  Published 2 December 2013.

A population-based approach to improving outcomes for people with chronic obstructive pulmonary disease based on the cost of delivering those outcomes.

Published July 2012.    BMJ Editorial http://www.bmj.com/content/345/bmj.e6192

A population-based approach to improving outcomes for people with chronic obstructive
pulmonary disease based on the cost of delivering those outcomes.

Published July 2012

ISSN 2040-2023:British Thoracic Society Reports, Vol 4, Issue 2, 2012