Use of short-acting opioids in the management of breathlessness: An evidence-based review

Research output: Contribution to journalReview articlepeer-review

12 Scopus citations

Abstract

Purpose of review To provide an evidence-based review on the use of short-acting opioids for management of breathlessness in patients with advanced diseases. Recent findings We identified 28 randomized controlled trials that examined the effect of short-acting opioids on breathlessness under three study settings: As a prophylactic dose given prior to exertion; as a rescue dose for treatment of breathlessness at rest or episodic breathlessness; or as a scheduled medication for overall reduction of breathlessness. These trials varied widely in regard to patient population (opioid naive or tolerant), opioid (formulation, dose, timing of administration, and scheduling) and control intervention. Taken together, there is good evidence to support that short-acting opioids can reduce breathlessness and improve activity level when given before exertion. There is some evidence that parenteral opioids are efficacious for the as needed treatment of episodic breathlessness or breathlessness at rest. However, there is only limited evidence to support scheduled short-acting opioids for overall relief of breathlessness. Summary There is evidence to support that short-acting opioids have a pharmacologic effect on breathlessness. More research is needed to clarify how opioids can be prescribed to optimize breathlessness relief, function, and quality of life.

Original languageEnglish (US)
Pages (from-to)167-176
Number of pages10
JournalCurrent opinion in supportive and palliative care
Volume14
Issue number3
DOIs
StatePublished - Sep 2020

Keywords

  • Chronic obstructive pulmonary disease
  • Dyspnea
  • Exercise
  • Heart failure
  • Opioids
  • Palliative care
  • Randomized trials

ASJC Scopus subject areas

  • Oncology
  • Oncology(nursing)
  • Critical Care and Intensive Care Medicine

Fingerprint

Dive into the research topics of 'Use of short-acting opioids in the management of breathlessness: An evidence-based review'. Together they form a unique fingerprint.

Cite this