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Patients��� and caregivers��� experiences of driving with chronic breathlessness before and after regular low-dose sustained-release morphine: A qualitative study

Journal Article


Abstract


  • Background: Chronic breathlessness is a disabling syndrome that profoundly impacts patients��� and caregivers��� lives. Driving is important for most people, including those with advanced disease. Regular, low-dose, sustained-release morphine safely reduces breathlessness, but little is known about its impact on driving. Aim: To understand patients��� and caregivers��� (1) perspectives and experiences of driving with chronic breathlessness; and (2) perceived impact of regular, low-dose, sustained-release morphine on driving. Design: A qualitative study embedded in a pragmatic, phase III, randomised, placebo-controlled trial of low-dose, sustained-release morphine (���32 mg/24 h) for chronic breathlessness. Semi-structured interviews were conducted immediately after participants withdrew or completed the randomised, placebo-controlled trial. Informed by grounded theory, a constant comparative approach to analysis was adopted. Setting/participants: Participants were recruited from an outpatients palliative care service in Adelaide, Australia. Participants included patients (n = 13) with severe breathlessness associated with chronic obstructive pulmonary disease and their caregivers (n = 9). Results: Participants were interviewed at home. Eleven received morphine 8���32 mg. Three themes emerged: (1) independence; (2) breathlessness��� impact on driving; and (3) driving while taking regular, low-dose, sustained-release morphine. Conclusion: Driving contributed to a sense of identity and independence. Being able to drive increased the physical and social space available to patients and caregivers, their social engagement and well-being. Patients reported breathlessness at rest may impair driving skills, while the introduction of sustained-release morphine seemed to have no self-reported impact on driving. Investigating this last perception objectively, especially in terms of safety, is the subject of ongoing work.

UOW Authors


  •   Marques Barroso Honorio Ferreira, Diana (external author)
  •   Kochovska, Slavica (external author)
  •   Currow, David

Publication Date


  • 2020

Citation


  • Ferreira, D. H., Boland, J. W., Kochovska, S., Honson, A., Phillips, J. L., & Currow, D. C. (2020). Patients��� and caregivers��� experiences of driving with chronic breathlessness before and after regular low-dose sustained-release morphine: A qualitative study. Palliative Medicine, 34(8), 1078-1087. doi:10.1177/0269216320929549

Scopus Eid


  • 2-s2.0-85086234088

Start Page


  • 1078

End Page


  • 1087

Volume


  • 34

Issue


  • 8

Place Of Publication


Abstract


  • Background: Chronic breathlessness is a disabling syndrome that profoundly impacts patients��� and caregivers��� lives. Driving is important for most people, including those with advanced disease. Regular, low-dose, sustained-release morphine safely reduces breathlessness, but little is known about its impact on driving. Aim: To understand patients��� and caregivers��� (1) perspectives and experiences of driving with chronic breathlessness; and (2) perceived impact of regular, low-dose, sustained-release morphine on driving. Design: A qualitative study embedded in a pragmatic, phase III, randomised, placebo-controlled trial of low-dose, sustained-release morphine (���32 mg/24 h) for chronic breathlessness. Semi-structured interviews were conducted immediately after participants withdrew or completed the randomised, placebo-controlled trial. Informed by grounded theory, a constant comparative approach to analysis was adopted. Setting/participants: Participants were recruited from an outpatients palliative care service in Adelaide, Australia. Participants included patients (n = 13) with severe breathlessness associated with chronic obstructive pulmonary disease and their caregivers (n = 9). Results: Participants were interviewed at home. Eleven received morphine 8���32 mg. Three themes emerged: (1) independence; (2) breathlessness��� impact on driving; and (3) driving while taking regular, low-dose, sustained-release morphine. Conclusion: Driving contributed to a sense of identity and independence. Being able to drive increased the physical and social space available to patients and caregivers, their social engagement and well-being. Patients reported breathlessness at rest may impair driving skills, while the introduction of sustained-release morphine seemed to have no self-reported impact on driving. Investigating this last perception objectively, especially in terms of safety, is the subject of ongoing work.

UOW Authors


  •   Marques Barroso Honorio Ferreira, Diana (external author)
  •   Kochovska, Slavica (external author)
  •   Currow, David

Publication Date


  • 2020

Citation


  • Ferreira, D. H., Boland, J. W., Kochovska, S., Honson, A., Phillips, J. L., & Currow, D. C. (2020). Patients��� and caregivers��� experiences of driving with chronic breathlessness before and after regular low-dose sustained-release morphine: A qualitative study. Palliative Medicine, 34(8), 1078-1087. doi:10.1177/0269216320929549

Scopus Eid


  • 2-s2.0-85086234088

Start Page


  • 1078

End Page


  • 1087

Volume


  • 34

Issue


  • 8

Place Of Publication