NON-FARMACOLOGICAL breathlessness action plans may help people with Chronic Obstructive Pulmonary Disease (COPD) manage acute episodes and avoid emergency care.
COPD Breathlessness Action Plans in Current Practice
Breathlessness action plans are designed to help people with COPD respond to acute-on-chronic episodes of breathlessness using non-pharmacological strategies. In this scoping review and survey of current practice, investigators examined what plans are currently available, how they were developed, what they include, how usable they are, and whether there is evidence that they improve outcomes.
The analysis identified 69 English-language breathlessness action plans for people with COPD. Most plans included breathing techniques, which appeared in 88% of materials. Positioning was included in 78%, airflow strategies in 65%, and relaxation or distraction in 36%. Other less commonly included components were stopping or slowing down, remaining calm, reassurance, support from others, and loosening clothing.
Quality and Evidence Remain Limited
Although many plans were available, their overall quality was mixed. Among the 48 plans that could be assessed using the Patient Education Materials Assessment Tool, the mean understandability score was 64% and the mean actionability score was 68%. The median reading grade was 8.2, suggesting that some materials may still be too complex for parts of the target population.
Evidence supporting these breathlessness action plans was limited. The authors found efficacy data from only one pre and post study, along with feasibility and acceptability findings from qualitative data in two feasibility trials. Each of those studies evaluated a different plan, leaving major evidence gaps around which format or content is most effective.
Survey Findings Suggest Potential Benefit
Despite the limited formal evidence base, survey responses suggested these plans may provide real-world value. Among plan users, 67% reported that using their plan had helped them avoid calling an ambulance over the previous year. Clinician responses were also broadly positive. Most clinicians perceived that breathlessness action plans improved patient confidence and reduced anxiety. Many also believed the plans reduced episode frequency, lowered the need for ambulance or emergency department care, and supported activities of daily living.
The authors concluded that while breathlessness action plans are already in use and appear promising, further research is needed to determine their net effects on self-management, breathlessness outcomes, and healthcare utilization in COPD.
Reference
Luckett T et al. Non-Pharmacological Breathlessness Action Plans for People with COPD and Their Support People: A Scoping Review and Survey of Current Practice. Int J Chron Obstruct Pulmon Dis. 2026;11:21:568299.
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