Abstract
Refractory breathlessness is common and undertreated in patients with advanced COPD. Dyspnoea management is often complex and may include opioids, however there is a perceived reluctance to utilise this treatment option. Aims: To examine physicians9 attitudes to dyspnoea management for COPD patients. Methods: 2161 specialists and registrars in respiratory medicine (RM) (n=940) and palliative medicine (PM) (n=1221) in Australia, New Zealand and the UK were invited by email to complete an on-line, case-vignette based survey. Results: Overall response rate 27% (n=574) and 446 completed dyspnoea management questions. In a stable optimally managed COPD patient, 115 (63%) RM physicians and 220 (84%) PM physicians recommended adding a medication for refractory dyspnoea. A further 12 (7%) RM physicians and 19 (7%) PM physicians would consider this option. In practice, only 65 (36%) RM physicians, compared with 213 (81%) PM physicians reported regularly prescribing opioids for COPD patients with refractory breathlessness. Conclusions: While physicians recognised the role of opioids for refractory dyspnoea in COPD, this was not part of routine dyspnoea management for RM physicians.
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