Sep 2, 2021
This episode features Florence Reedy (Wolfson Palliative Care
Research Centre, Hull York Medical School, University of Hull,
Hull, UK).
Chronic breathlessness is a prevalent symptom amongst patients with
advanced medical conditions. In combination with disease-modifying
therapies and non-pharmacological interventions, regular low
dose opioids may safely reduce moderate to severe chronic
breathlessness due to advanced medical conditions. Implementation
of opioids for chronic breathlessness in clinical practice varies
widely.
Clinicians’ and patients’ fears of opioids causing respiratory
depression, addiction and regulatory scrutiny are significant
barriers in the use of opioids for breathlessness. Education and
information are necessary, but insufficient as a sole
strategy, to improve implementation of opioid use for this
indication. Clinicians’ interactions with patients and their
families strongly influence acceptance of, and adherence to
opioid treatment regimens for chronic breathlessness.
An agreed protocol for opioid initiation, titration and monitoring
for use by clinicians in conjunction with agreed clinical
guidelines may improve both their knowledge and confidence around
opioid use for the symptomatic reduction of chronic breathlessness.
Additional research on patients’ and carers’ experiences of opioids
for chronic breathlessness is necessary to inform better
implementation of opioids into clinical practice.