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. 2024 May 2;4(5):e0002655.
doi: 10.1371/journal.pgph.0002655. eCollection 2024.

Prevalence, severity and impacts of breathlessness in Indian adults: An exploratory, nationally representative, cross-sectional online survey

Slavica Kochovska  1 , Rajam Iyer  2 , Sungwon Chang  3 , Diana Ferreira  1 , Vanessa N Brunelli  1 , Irina Kinchin  4 , Danny J Eckert  5 , Joseph Clark  6 , Jacob Sandberg  7 , Magnus Ekström  7 , David Currow  1 , Sujeet Rajan  8
Affiliations

Prevalence, severity and impacts of breathlessness in Indian adults: An exploratory, nationally representative, cross-sectional online survey

Slavica Kochovska et al. PLOS Glob Public Health. .

Abstract

There are no known estimates of the prevalence, severity and impacts from breathlessness in low- and middle-income countries. This study aimed to explore the prevalence, severity, self-attributed underlying conditions and impacts of breathlessness limiting exertion in community-dwelling adults in India. This exploratory, population-based online survey recruited a pre-planned sample of 3,000 adult respondents stratified by age, sex and rurality (quotas as per the 2011 Indian National Census). Measures included: demographics; breathlessness limiting exertion (modified Medical Research [mMRC] scale); health-related quality of life (EQ-5D-5L); and disability (World Health Organisation's Disability Assessment Schedule 2.0 12-item questionnaire [WHODAS-12]). Respondents (n = 3,046) had a mean age of 38 years (SD 15); 57% were male, 59% lived in rural areas and 33% had completed 12th grade. Breathlessness limiting exertion (mMRC ≥1) was reported by 44%, mostly attributed to poor nutrition (28%), lung conditions excluding tuberculosis (17%) or anaemia (13%). Compared to those without breathlessness, a higher proportion of people with breathlessness (mMRC ≥1) reported problems across all EQ-5D-5L dimensions. Most people reporting breathlessness (81%) indicated the symptom had adversely affected their normal activities. Disability scores (WHODAS-12 total and individual domains) increased as breathlessness worsened. To conclude, in India, conservative estimates indicate 626 million people live with breathlessness of whom 52 million people live with severe breathlessness. The symptom is associated with poorer health-related quality of life and marked disability, including reduced ability to perform daily activities.

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Conflict of interest statement

DCC is an unpaid member of an advisory board for Helsinn Pharmaceuticals and Specialist Therapeutics, and has consulted to, and received intellectual property payments from Mayne Pharma. DJE is funded by a National Health and Medical Research Council of Australia Leadership Fellowship (1116942). Outside the current work, DJE has received research grants from Bayer, Takeda, Invicta Medical, Withings, Eli Lilly, and Apnimed and has served on Scientific Advisory Boards for Apnimed, Invicta, Mosanna, and as a consultant for Bayer. All other authors declare no competing interests. There are no patents, products in development or marketed products to declare. This does not alter our adherence to PLOS ONE policies on sharing data and materials.

Figures

Fig 1
Fig 1. Proportion of moderate-to-extreme problems by quality of life (EQ-5D-5L) dimensions and level of breathlessness (modified Medical Research [mMRC] breathlessness scale) reported by 3,046 community-dwelling adults in an online survey for India [weighted data].
Fig 2
Fig 2. Mean disability scores with 95% CIs for WHODAS-12 individual domains and level of breathlessness (modified Medical Research Council [mMRC] breathlessness scale) reported by 3,046 community-dwelling adults in an online survey for India [weighted data].
See this image and copyright information in PMC

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