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
David C. Currow
Miriam J. Johnson
J. Martin Bland
Professor Miriam Johnson Miriam.Johnson@hull.ac.uk
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|
|Publisher||BMJ Publishing Group|
|Peer Reviewed||Peer Reviewed|
|APA6 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|
|Keywords||Palliative care, COPD pharmacology, Perception of asthma/breathlessness|
|Copyright Statement||©2017 University of Hull|
|Additional Information||This is a description of an article accepted for publication in: Thorax, 2017|
©2017 University of Hull