Improving patient preparation and comfort in voluntary DIBH – Single-centre quality improvement evaluation

Abstract

Introduction

Voluntary deep-inspiration breath-hold (vDIBH) is commonly used in left breast cancer patients during radiotherapy to reduce cardiac dose and improve setup accuracy. However, some patients have trouble maintaining a consistent, adequate, breath-hold during radiotherapy. This service evaluation assessed the impact of the RESPIRE tool—an online resource offering instructional videos and audio guides—introduced prior to simulation to improve patient compliance and preparedness.

Methods

Fifteen eligible breast cancer patients received RESPIRE information during a clinic appointment for Radiotherapy consent, followed by a telephone check-in prior to CT planning. Breath-hold quality was assessed using planning CT metrics and treatment-image reproducibility, and patient experience was qualitatively evaluated.

Results

Compared to historical controls, the fifteen RESPIRE users reported feeling significantly more prepared, and blinded reviews of CBCT images confirmed improved breath-hold reproducibility. Lung volume increased by an average of 32 %, and heart-to-chest wall separation improved following use of the tool.

Conclusion

The results align with existing evidence that guided preparation reduces anxiety and supports successful vDIBH implementation. The intervention addresses current ESTRO-ACROP and national safety priorities by promoting patient engagement, comfort, and technical accuracy.

Implications for practice

Pre-treatment education using scalable tools like RESPIRE offers a low-cost, high-impact strategy to enhance radiotherapy outcomes and patient-centred care. Future work could hope to make this tool accessible to a wider cohort of patients, addressing some of the limitations discussed.