Development of a physiotherapist-led remote breathlessness clinic for community lung patients: the Respiratory Advice and Management Physiotherapy (RAMP) service

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Introduction: During the Covid-19 pandemic there was an urgent need to provide specialist support to breathless respiratory patients in the community, in the absence of face-to-face interactions. The Respiratory Advice and Management Physiotherapy (RAMP) service was set up to assess the impact of a physiotherapist-led remote breathlessness clinic, for the treatment of community respiratory patients. Methods: The service was available via e-mail referrals from primary care nurses and general practitioners in the region of Somerset, UK from May-December 2020. Patients were contacted by a Respiratory physiotherapist, via telephone, for breathlessness management advice. A postal questionnaire was used to obtain anonymous patient feedback, with data collected prospectively. Results: 243 patients were referred to the RAMP service. 54% female, mean age 66 (SD 14). 143 (58.4%) had chronic obstructive pulmonary disease (COPD), 72 (29.3%) asthma, 17 (7%) bronchiectasis and 13 (5.3%) had other conditions. 125 patients agreed to receiving a questionnaire and 77 responses were received. 84% of patients were highly satisfied with the service, 77% felt significantly better at managing their breathlessness and 82% would recommend the service to other patients with long term chest conditions. Conclusion: The RAMP service has highlighted an unmet need for physiotherapist-led support to community respiratory patients and has demonstrated a positive impact on the self-management of their breathlessness. Further work should be undertaken to evaluate the benefits of specialist physiotherapy delivered remote clinics, following the pandemic.

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