Background: Breathlessness is common, anxiety-provoking, and challenging to clarify in primary care. When it persists beyond four weeks, it markedly impairs quality of life, functional capacity, and prognosis, and can trigger urgent consultations if underlying causes are not recognized and managed. Chronic breathlessness is frequently multifactorial, combining cardiopulmonary disease with obesity, deconditioning, breathing pattern disorders, anxiety, anemia, and post-coronavirus disease 2019 conditions.
Objective: This technical sheet aimed to provide primary care physicians with a structured, pragmatic, person-centered approach to the assessment and management of chronic breathlessness.
Content: This technical sheet emphasized early identification of acute/urgent presentations of breathlessness in adults (including pulse oximetry when available), systematic evaluation (history, examination, accessible investigations such as spirometry, chest radiography, electrocardiogram, complete blood count, N-terminal pro–B-type natriuretic peptide, and screening for anxiety/depression and physical activity level), and staged diagnostic reasoning that may require several visits while safely managing uncertainty. Management includes optimizing treatment of underlying conditions according to national guidance and early introduction of evidence-based non-pharmacological strategies. The breathing–thinking–functioning model is proposed to structure symptom control: correcting maladaptive breathing patterns, addressing fear and distress, and tackling deconditioning through appropriate rehabilitation and activity support.
Conclusion: A structured primary-care pathway combined with early non-pharmacological interventions can improve consultations, support self-management, and enhance outcomes in adults with chronic breathlessness.