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

Ekström, Magnus LU ; Bajwah, Sabrina; Bland, J. Martin; Currow, David C.; Hussain, Jamilla and Johnson, Miriam J. (2018) In Thorax 73(1). p.88-90
Abstract

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.

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author
organization
publishing date
type
Contribution to journal
publication status
published
subject
keywords
COPD Pharmacology, Palliative Care, Perception of Asthma/Breathlessness
in
Thorax
volume
73
issue
1
pages
3 pages
publisher
BMJ Publishing Group
external identifiers
  • scopus:85039059825
ISSN
1468-3296
DOI
language
English
LU publication?
yes
id
9f281098-aeeb-4da7-aa21-f9d381395dd7
date added to LUP
2018-01-22 10:37:18
date last changed
2018-06-17 05:30:04
@article{9f281098-aeeb-4da7-aa21-f9d381395dd7,
  abstract     = {<p>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.</p>},
  author       = {Ekström, Magnus and Bajwah, Sabrina and Bland, J. Martin and Currow, David C. and Hussain, Jamilla and Johnson, Miriam J.},
  issn         = {1468-3296},
  keyword      = {COPD Pharmacology,Palliative Care,Perception of Asthma/Breathlessness},
  language     = {eng},
  number       = {1},
  pages        = {88--90},
  publisher    = {BMJ Publishing Group},
  series       = {Thorax},
  title        = {One evidence base; three stories : do opioids relieve chronic breathlessness?},
  url          = {http://dx.doi.org/},
  volume       = {73},
  year         = {2018},
}