Attitudes of patients with chronic breathlessness towards treatment with opioids. Issue 2 (20th February 2020)

• Record Type: Journal Article
• Authors: Verberkt, Cornelia A.; van den Beuken-van Everdingen, Marieke H.J.; Wouters, Emiel F.M.; Janssen, Daisy J.A.
• Is Part Of: European respiratory journal. Volume 55:Issue 2(2020)
• Publication Date: 2020-02-20
• Subjects: Respiratory organs -- Diseases -- Periodicals; Respiration -- Periodicals; 616.2
• DOI: 10.1183/13993003.01752-2019
• Languages: English
• ISSNs: 0903-1936

Abstract

Breathlessness is the most common symptom in advanced chronic lung disease or chronic heart failure (CHF) [1]. Opioids are recommended for palliative treatment of breathlessness persisting despite optimal pharmacological and non-pharmacological treatment [2, 3]. However, physicians don't always consider opioids for chronic breathlessness [4, 5] and experience barriers when considering opioids, such as resistance of patients [6]. This can limit effective palliative treatment. Qualitative studies in patients with COPD and CHF revealed fear of dependence and fear of imminent death as the most important barriers to opioid use. The reason to start treatment was to do as much as possible [7–9]. These qualitative studies were only conducted in small patient populations. Therefore, our aims were to assess the willingness of patients with chronic lung disease or CHF to use opioids for breathlessness, irrespective of a current indication for opioid treatment; and to assess their barriers towards opioid use and reasons to use opioids. Finally, we aimed to compare willingness differences according to sex, age, educational level, diagnosis and breathlessness severity. Attitudes of patients towards opioid treatment for chronic breathlessness are mixed, with 37% of patients willing to use opioids, 25% unwilling and 38% of patients indecisive. Physicians are an important source of information for these patients. http://bit.ly/2pvNtLJ