Extract
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.
Abstract
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
Acknowledgements
We would like to thank Miranda Coenjaerds (CIRO, Horn, the Netherlands) for contributing to the data collection. Furthermore, we would like to thank Liesbeth van Hoef and Wendy Engering (Centre of Expertise for Palliative Care, Maastricht University Medical Centre (MUMC+), Maastricht, the Netherlands) for entering the data.
Footnotes
Conflict of interest: C.A. Verberkt reports grants from ZonMW (836031012), the Hague, during the conduct of the study.
Conflict of interest: M.H.J. van den Beuken-van Everdingen reports grants from ZonMW (836031012), during the conduct of the study.
Conflict of interest: E.F.M Wouters reports personal fees for advisory board work from Nycomed and Boehringer, grants from AstraZeneca and GSK, personal fees for lectures from AstraZeneca, GSK, Novartis and Chiesi, outside the submitted work.
Conflict of interest: D.J.A. Janssen reports grants from The Netherlands Organisation for Health Research and Development (ZonMW; grant 836031012), the Hague, the Netherlands, during the conduct of the study; personal fees for lectures from Boehringer Ingelheim, Novartis and AstraZeneca, outside the submitted work.
Support statement: This project was funded by the Netherlands Organisation for Health Research and Development (ZonMW), the Hague, the Netherlands (grant number 836031012). Funding information for this article has been deposited with the Crossref Funder Registry.
- Received September 5, 2019.
- Accepted October 24, 2019.
- Copyright ©ERS 2020
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