We found a match
Your institution may have access to this item. Find your institution then sign in to continue.
- Title
Can We Predict Which Patients with Refractory Dyspnea Will Respond to Opioids?
- Authors
Currow, David C.; Plummer, John; Frith, Peter; Abernethy, Amy P.
- Abstract
Introduction: Dyspnea is frequently encountered in end-stage diseases even when reversible issues are addressed. Which clinical factors best define patient subpopulations that will most predictably benefit from opioids in this clinical setting? Methods: Thirty-eight patients with refractory dyspnea were randomized to an 8-day crossover trial of 4 days of 20 mg sustained release morphine or placebo, switching arms on day 5 (Clinical Trial Registry Number: ACTRN012607000075482). Dyspnea was measured on a 100-mm visual analogue scale (VAS). Day 4 and day 8 morning and evening VAS scores were the primary outcome. Correlation between baseline dyspnea and response to opioids was explored; potentially important clinical predictors tested with two-sided Student's t test. Results: In this exploratory study, no relationship could be defined between baseline dyspnea and response to opioids (Spearman correlation 0.03, p = 0.88). The study was not powered to define other predictors, but younger age, better functional status, and significant cardiac findings on entry to the study deserve further prospective evaluation in a larger cohort. Discussion: Phase 4 pharmaco-vigilance trials are needed in palliative care to define people who are most likely to experience a net benefit from treatment such as opioids for refractory dyspnea.
- Subjects
MEDICAL research; PALLIATIVE treatment; CLINICAL trials; DYSPNEA; PATIENTS
- Publication
Journal of Palliative Medicine, 2007, Vol 10, Issue 5, p1031
- ISSN
1096-6218
- Publication type
Article
- DOI
10.1089/jpm.2007.9912