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Patients’ and caregivers’ experiences of driving with chronic breathlessness before and after regular low-dose sustained-release morphine: A qualitative study

Ferreira, Diana H; Boland, Jason W; Kochovska, Slavica; Honson, Aaron; Phillips, Jane L; Currow, David C

Authors

Diana H Ferreira

Jason W Boland

Slavica Kochovska

Aaron Honson

Jane L Phillips

David C Currow



Abstract

Background:
Chronic breathlessness is a disabling syndrome that profoundly impacts patients’ and caregivers’ lives. Driving is important for most people, including those with advanced disease. Regular, low-dose, sustained-release morphine safely reduces breathlessness, but little is known about its impact on driving.

Aim:
To understand patients’ and caregivers’ (1) perspectives and experiences of driving with chronic breathlessness; and (2) perceived impact of regular, low-dose, sustained-release morphine on driving.

Design:
A qualitative study embedded in a pragmatic, phase III, randomised, placebo-controlled trial of low-dose, sustained-release morphine (⩽32 mg/24 h) for chronic breathlessness. Semi-structured interviews were conducted immediately after participants withdrew or completed the randomised, placebo-controlled trial. Informed by grounded theory, a constant comparative approach to analysis was adopted.

Setting/participants:
Participants were recruited from an outpatients palliative care service in Adelaide, Australia. Participants included patients (n = 13) with severe breathlessness associated with chronic obstructive pulmonary disease and their caregivers (n = 9).

Results:
Participants were interviewed at home. Eleven received morphine 8–32 mg. Three themes emerged: (1) independence; (2) breathlessness’ impact on driving; and (3) driving while taking regular, low-dose, sustained-release morphine.

Conclusion:
Driving contributed to a sense of identity and independence. Being able to drive increased the physical and social space available to patients and caregivers, their social engagement and well-being. Patients reported breathlessness at rest may impair driving skills, while the introduction of sustained-release morphine seemed to have no self-reported impact on driving. Investigating this last perception objectively, especially in terms of safety, is the subject of ongoing work.

Journal Article Type Article
Journal Palliative Medicine
Print ISSN 0269-2163
Electronic ISSN 1477-030X
Publisher SAGE Publications
Peer Reviewed Peer Reviewed
APA6 Citation Ferreira, D. H., Boland, J. W., Kochovska, S., Honson, A., Phillips, J. L., & Currow, D. C. (in press). Patients’ and caregivers’ experiences of driving with chronic breathlessness before and after regular low-dose sustained-release morphine: A qualitative study. Palliative medicine, https://doi.org/10.1177/0269216320929549
DOI https://doi.org/10.1177/0269216320929549
Keywords Driving; Opioids; Morphine; Breathlessness; Dyspnoea; Caregivers; Patients
Publisher URL https://journals.sagepub.com/doi/10.1177/0269216320929549

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©2020 The authors. All rights reserved. No part of this publication may be reproduced without the written permission of the copyright holder





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