Do COPD patients taught pursed lips breathing (PLB) for dyspnoea management continue to use the technique long-term? A mixed methodological study

Abstract

Objective: To investigate whether COPD patients taught pursed lips breathing (PLB) for dyspnoea management continue to use the technique long-term and, if so, their experience of this.

Design: A mixed methodological approach using semi-structured telephone interviews, a focus group and observation of current PLB technique was used. Qualitative analysis was based on grounded theory.

Setting: Participants were recruited from the two inner city London (UK) boroughs.

Participants: A purposive sample of 13 patients with COPD taught PLB 6 to 24 months previously. 11 participants took part in the telephone interviews; focus group participation and observed PLB was 5/11 and 6/11 respectively.

Main outcome measures: A thematic analysis of interviews and focus group; observation of PLB technique.

Results: Nine reported on-going use of PLB with 8 reporting definite benefit. Observed technique showed ongoing ability for PLB to reduce RR and increase SpO₂. Four distinct themes emerged from the data: use of PLB when short of breath due to physical activity (8/9), increased confidence and reduced panic (4/9), use as an exercise (3/9), use at night (3/9). Those that had discontinued PLB had done so because it didn't help (2) and they had forgotten/were too busy to continue.

Conclusion: This study found 9 of 13 of patients taught PLB continued with long-term use and 8 of 13 reporting definite benefit from PLB. The role of PLB in increasing patients' confidence in their ability to manage their breathlessness and, use at night, were novel findings.

Keywords: Breathing exercises; Chronic Obstructive Pulmonary Disease; Dyspnoea; Rehabilitation.