Prevalence and assessment of breathlessness in the clinical setting.

Breathlessness is a common symptom in the general population and a frequent reason for presentation in all healthcare settings. It causes serious functional limitations, distress for both patient and carer, and predicts poor clinical outcomes. Traditionally, clinical care focuses on investigation, diagnosis and treatment of the conditions causing breathlessness. Breathlessness itself is often not seen as a target for therapeutic interventions by either clinician or patient, and so breathlessness which persists despite optimum treatment of the condition is self-managed by the patient without medical help. There are evidence based interventions which benefit breathlessness, irrespective of its cause; systematic assessment should lead to individually tailored management plans. A simple measure of severity (intensity) and assessment of bother or distress caused by breathlessness in addition to the impact on quality of life should be routinely sought in a proactive manner so that appropriate management plans can be put in place.