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One evidence base; three stories: do opioids relieve chronic breathlessness?

Ekstrom, Magnus; Currow, David C.; Johnson, Miriam J.; Ekström, Magnus; Bajwah, Sabrina; Bland, J. Martin; Currow, David; Hussain, Jamilla; Johnson, Miriam

Authors

Magnus Ekstrom

David C. Currow

Miriam J. Johnson

Magnus Ekström

Sabrina Bajwah

J. Martin Bland

David Currow

Jamilla Hussain

Abstract

Published by the BMJ Publishing Group Limited. For permission to use (where not already granted under a licence) please go to http://www.bmj.com/company/products-services/rights-and-licensing/. The efficacy of low-dose systemic opioids for chronic breathlessness was questioned by the recent Cochrane review by Barnes et al We examined the reasons for this conflicting finding and re-evaluated the efficacy of systemic opioids. Compared with previous meta-analyses, Barnes et al reported a smaller effect and lower precision, but did not account for matched data of crossover trials (11/12 included trials) and added a risk-of-bias criterion (sample size). When re-analysed to account for crossover data, opioids decreased breathlessness (standardised mean differences -0.32; -0.18 to -0.47; I2=44.8%) representing a clinically meaningful reduction of 0.8 points (0-10 numerical rating scale), consistent across meta-analyses.

Journal Article Type Letter
Publication Date 2018
Journal Thorax
Print ISSN 0040-6376
Electronic ISSN 1468-3296
Publisher BMJ Publishing Group
Peer Reviewed Peer Reviewed
Volume 73
Issue 1
Pages 88-90
Institution Citation Ekstrom, M., Currow, D. C., Johnson, M. J., Ekström, M., Bajwah, S., Bland, J. M., …Johnson, M. (2018). One evidence base; three stories: do opioids relieve chronic breathlessness?. Thorax, 73(1), 88-90. https://doi.org/10.1136/thoraxjnl-2016-209868
DOI https://doi.org/10.1136/thoraxjnl-2016-209868
Keywords Palliative care, COPD pharmacology, Perception of asthma/breathlessness
Publisher URL http://thorax.bmj.com/content/early/2017/04/04/thoraxjnl-2016-209868
Copyright Statement ©2017 University of Hull
Additional Information This is a description of an article accepted for publication in: Thorax, 2017

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