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

Ekström, Magnus LU orcid ; 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
; ; ; ; and
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
  • pmid:28377491
ISSN
1468-3296
DOI
10.1136/thoraxjnl-2016-209868
language
English
LU publication?
yes
id
9f281098-aeeb-4da7-aa21-f9d381395dd7
date added to LUP
2018-01-22 10:37:18
date last changed
2024-03-01 11:18:28
@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}},
  keywords     = {{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/10.1136/thoraxjnl-2016-209868}},
  doi          = {{10.1136/thoraxjnl-2016-209868}},
  volume       = {{73}},
  year         = {{2018}},
}