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The impact of regular, low-dose, sustained-release morphine for chronic breathlessness on caregiver burden : An exploratory analysis of the BEAMS trial

Kochovska, Slavica ; Ferreira, Diana ; Chang, Sungwon ; Luckett, Tim ; Roydhouse, Jessica ; Ekström, Magnus LU orcid and Currow, David C. (2023) In Palliative Medicine
Abstract

Background: Chronic breathlessness adversely impacts people with chronic obstructive pulmonary disease and their caregivers (family and friends), who may, in turn, experience significant burden due to their caregiving role. Sustained-release morphine may reduce chronic breathlessness in some patients, which may have an impact on caregivers’ perceived burden. Aim: To explore the impact on caregiver burden of active treatment of people with chronic breathlessness (modified Medical Research Council (mMRC) ⩾ 3) and chronic obstructive pulmonary disease (COPD) with regular, low-dose, sustained-release morphine within a multi-site, double-blind, randomised, placebo-controlled trial. Design: Exploratory analysis of self-reported caregiver... (More)

Background: Chronic breathlessness adversely impacts people with chronic obstructive pulmonary disease and their caregivers (family and friends), who may, in turn, experience significant burden due to their caregiving role. Sustained-release morphine may reduce chronic breathlessness in some patients, which may have an impact on caregivers’ perceived burden. Aim: To explore the impact on caregiver burden of active treatment of people with chronic breathlessness (modified Medical Research Council (mMRC) ⩾ 3) and chronic obstructive pulmonary disease (COPD) with regular, low-dose, sustained-release morphine within a multi-site, double-blind, randomised, placebo-controlled trial. Design: Exploratory analysis of self-reported caregiver burden at baseline and end of week 3 in a randomised, double-blind, placebo-controlled study. Caregiver measures included: demographics and perceived burden (Zarit Burden Interview 12-item short-form questionnaire). Patient measures included: worst breathlessness and FitBitR-measures. Setting/participants: All consenting caregivers of trial patient participants in a multi-site study recruiting from palliative care and respiratory services. Results: Caregivers (n = 49; 59% women; median age 68 years [IQR 50–75]) reported median baseline caregiver burden 12 [IQR 5–17], with 53% reporting high burden (⩾13). Eighty-four percent of caregivers reported no change in burden. In people whose worst breathlessness improved, caregiver burden moved in the same direction, though the correlation was not significant (rs = 0.25, p = 0.17). Conversely, caregiver burden worsened as patients’ minutes lightly active increased, with the correlation being significant (rs = 0.56, p = 0.04). Conclusions: Caregivers reported high levels of caregiver burden, but patients’ response to treatment in terms of their symptom and function may influence change in caregiver burden over a three-week period.

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author
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organization
publishing date
type
Contribution to journal
publication status
in press
subject
keywords
caregiver burden, Chronic breathlessness, chronic obstructive pulmonary disease, randomised controlled trial
in
Palliative Medicine
publisher
SAGE Publications
external identifiers
  • pmid:37978419
  • scopus:85177091317
ISSN
0269-2163
DOI
10.1177/02692163231211227
language
English
LU publication?
yes
id
c0e751b3-a740-407d-8f03-49928fa9d5a5
date added to LUP
2024-01-08 13:46:12
date last changed
2024-04-23 09:23:38
@article{c0e751b3-a740-407d-8f03-49928fa9d5a5,
  abstract     = {{<p>Background: Chronic breathlessness adversely impacts people with chronic obstructive pulmonary disease and their caregivers (family and friends), who may, in turn, experience significant burden due to their caregiving role. Sustained-release morphine may reduce chronic breathlessness in some patients, which may have an impact on caregivers’ perceived burden. Aim: To explore the impact on caregiver burden of active treatment of people with chronic breathlessness (modified Medical Research Council (mMRC) ⩾ 3) and chronic obstructive pulmonary disease (COPD) with regular, low-dose, sustained-release morphine within a multi-site, double-blind, randomised, placebo-controlled trial. Design: Exploratory analysis of self-reported caregiver burden at baseline and end of week 3 in a randomised, double-blind, placebo-controlled study. Caregiver measures included: demographics and perceived burden (Zarit Burden Interview 12-item short-form questionnaire). Patient measures included: worst breathlessness and FitBit<sup>R</sup>-measures. Setting/participants: All consenting caregivers of trial patient participants in a multi-site study recruiting from palliative care and respiratory services. Results: Caregivers (n = 49; 59% women; median age 68 years [IQR 50–75]) reported median baseline caregiver burden 12 [IQR 5–17], with 53% reporting high burden (⩾13). Eighty-four percent of caregivers reported no change in burden. In people whose worst breathlessness improved, caregiver burden moved in the same direction, though the correlation was not significant (r<sub>s</sub> = 0.25, p = 0.17). Conversely, caregiver burden worsened as patients’ minutes lightly active increased, with the correlation being significant (r<sub>s</sub> = 0.56, p = 0.04). Conclusions: Caregivers reported high levels of caregiver burden, but patients’ response to treatment in terms of their symptom and function may influence change in caregiver burden over a three-week period.</p>}},
  author       = {{Kochovska, Slavica and Ferreira, Diana and Chang, Sungwon and Luckett, Tim and Roydhouse, Jessica and Ekström, Magnus and Currow, David C.}},
  issn         = {{0269-2163}},
  keywords     = {{caregiver burden; Chronic breathlessness; chronic obstructive pulmonary disease; randomised controlled trial}},
  language     = {{eng}},
  publisher    = {{SAGE Publications}},
  series       = {{Palliative Medicine}},
  title        = {{The impact of regular, low-dose, sustained-release morphine for chronic breathlessness on caregiver burden : An exploratory analysis of the BEAMS trial}},
  url          = {{http://dx.doi.org/10.1177/02692163231211227}},
  doi          = {{10.1177/02692163231211227}},
  year         = {{2023}},
}