Opioids effective in relieving severe shortness of breath in COPD patients

April 23, 2012 in Diseases, Conditions, Syndromes

Patients with advanced chronic obstructive pulmonary disease (COPD) and shortness of breath found that opioids provided relief and improved their quality of life, states an article in CMAJ (Canadian Medical Association Journal). However, physicians are reluctant to prescribe opioids for this condition, meaning many people will not benefit from this treatment.

The prevalence of in Canada is increasing, and shortness of breath (dyspnea) is a major symptom that is difficult to treat and can result in fear, anxiety and a decreased quality of life. Although opioids are often used to treat pain and dyspnea associated with malignant diseases, they are underused in COPD treatment. The Canadian Thoracic Society released a recommending the use of opioids for shortness of breath in patients with advanced COPD that doesn't respond to conventional treatment.

Researchers sought to understand physician attitudes toward this treatment and to understand the perspective of patients and their caregivers about the use of opioids for severe shortness of breath, known clinically as refractory dyspnea, that cannot be alleviated through other treatments. They interviewed 8 patients, 12 caregivers and 28 physicians in Nova Scotia, Canada. Patients had so severe that they could not leave their homes, or were breathless dressing or undressing, were on recommended therapies for COPD and long-term oxygen, and had been using opioids for dyspnea for five weeks to four years.

"All patients reported that opioids provided significant improvements to their quality of life, relief of dyspnea, or both, and cited this as their main reason to continue taking opioids over the longer term," write Dr. Graeme Rocker, Dalhousie University, Halifax, Nova Scotia, with coauthors.

Caregivers reported improvements in their family members' quality of life and for themselves as well.

"Many physicians indicated uncertainty and discomfort about prescribing opioids to patients with COPD," state the authors. "Lack of guidance, confidence and experience, a fear of respiratory suppression, and concern about censure were key factors limiting their willingness to prescribe opioids in this context. However, most acknowledged that dyspnea is difficult and frustrating to manage and thus were willing to consider opioids for this purpose."

"Discrepancies between the positive experiences of patients and family caregivers and the reluctance of physicians to prescribe opioids for refractory dyspnea constitute an important gap in care," write the authors. "Bridging this gap will likely require innovative educational initiatives to improve the uptake of guidelines and confidence in prescribing opioids for refractory dyspnea."

"Evidence is accumulating to suggest that soon the appropriate question will no longer be if we should prescribe opioids to help palliate refractory in patients living with advanced COPD, but rather how to do this competently and when," conclude the authors.

More information: Paper online: www.cmaj.ca/lookup… /cmaj.111758

Journal reference: Canadian Medical Association Journal search and more info website

Provided by Canadian Medical Association Journal search and more info website

not rated yet  

Rank not rated yet
Relevant PhysicsForums posts

More news stories

Estimates reveal low population immunity to new bird flu virus H7N9 in humans

The level of immunity to the recently circulating H7N9 influenza virus in an urban and rural population in Vietnam is very low, according to the first population level study to examine human immunity to the virus, which was ...

Diseases, Conditions, Syndromes created 2 hours ago | popularity not rated yet | comments 0 | with audio podcast

Study shows COPD is associated with significant and persistent pain

Chronic obstructive pulmonary disease (COPD) is primarily associated with the respiratory symptoms that are its hallmark, but in fact, patients who struggle with the disease also experience significant amounts of chronic ...

Diseases, Conditions, Syndromes created 2 hours ago | popularity not rated yet | comments 0

Inflammation is associated with depression in COPD patients

Depression is common in patients with chronic obstructive pulmonary disease (COPD) and has been linked with disease severity and impaired quality of life. Now, for the first time, researchers at the University of Pittsburgh ...

Diseases, Conditions, Syndromes created 2 hours ago | popularity not rated yet | comments 0

Study finds vitamin C can kill drug-resistant TB (w/ video)

In a striking, unexpected discovery, researchers at Albert Einstein College of Medicine of Yeshiva University have determined that vitamin C kills drug-resistant tuberculosis (TB) bacteria in laboratory culture. The finding ...

Diseases, Conditions, Syndromes created 2 hours ago | popularity 5 / 5 (2) | comments 0 | with audio podcast

Exercise levels may predict hospitalizations in COPD population

Clinical measurement of physical activity appears to be an independent predictor of whether or not patients with chronic obstructive pulmonary disease (COPD) will end up being hospitalized, according to a new study conducted ...

Diseases, Conditions, Syndromes created 4 hours ago | popularity not rated yet | comments 0


B vitamins could delay dementia

(Medical Xpress)—Despite spending billions of dollars on research and development, drug companies have been unable to come up with effective treatments for dementia and Alzheimer's Disease (AD). Now, A. ...

Enrichment therapy effective among children with autism, study finds

Children with autism showed significant improvement after six months of simple sensory exercises at home using everyday items such as scents, spoons and sponges, according to UC Irvine neurobiologists.

Poliovirus vaccine trial shows early promise for recurrent glioblastoma

An attack on glioblastoma brain tumor cells that uses a modified poliovirus is showing encouraging results in an early study to establish the proper dose level, researchers at Duke Cancer Institute report.

'Doctor shopping' by obese patients negatively affects health

Overweight and obese patients are significantly more likely than their normal-weight counterparts to repeatedly switch primary care doctors, a practice that disrupts continuity of care and leads to more emergency room visits, ...

Aggressive behavior linked specifically to secondhand smoke exposure in childhood

Children who are exposed to secondhand smoke in early childhood are more likely to grow up to physically aggressive and antisocial, regardless of whether they were exposed during pregnancy or their parents have a history ...

If you can remember it, you can remember it wrong

(Medical Xpress)—Native peoples in regions where cameras are uncommon sometimes react with caution when their picture is taken. The fear that something must have been stolen from them to create the photo ...