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One evidence base; Three stories: Do opioids relieve chronic breathlessness

Journal Article


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; I 2 =44.8%) representing a clinically meaningful reduction of 0.8 points (0-10 numerical rating scale), consistent across meta-analyses.

Publication Date


  • 2018

Publisher


Published In


Citation


  • Ekstr��m, M., Bajwah, S., Bland, J. M., Currow, D. C., Hussain, J., & Johnson, M. J. (2018). One evidence base; Three stories: Do opioids relieve chronic breathlessness. Thorax, 73(1), 88-90. doi:10.1136/thoraxjnl-2016-209868

Scopus Eid


  • 2-s2.0-85039059825

Start Page


  • 88

End Page


  • 90

Volume


  • 73

Issue


  • 1

Place Of Publication


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; I 2 =44.8%) representing a clinically meaningful reduction of 0.8 points (0-10 numerical rating scale), consistent across meta-analyses.

Publication Date


  • 2018

Publisher


Published In


Citation


  • Ekstr��m, M., Bajwah, S., Bland, J. M., Currow, D. C., Hussain, J., & Johnson, M. J. (2018). One evidence base; Three stories: Do opioids relieve chronic breathlessness. Thorax, 73(1), 88-90. doi:10.1136/thoraxjnl-2016-209868

Scopus Eid


  • 2-s2.0-85039059825

Start Page


  • 88

End Page


  • 90

Volume


  • 73

Issue


  • 1

Place Of Publication