Palliative care 2017

Intern Med J. 2015 Sep;45(9):898-904. doi: 10.1111/imj.12857.

Management of refractory breathlessness with morphine in patients with chronic obstructive pulmonary disease.

Smallwood N 1 , Le B 2 , Currow D 3 , Irving L 1 , Philip J 4 .

1 Department of Respiratory and Sleep Medicine, ²Palliative Care, The Royal Melbourne Hospital, Melbourne, Victoria, Australia.

3 Palliative and Supportive Services, Division of Medicine, Flinders University, Adelaide, South Australia, Australia.

4 Centre for Palliative Care, St Vincent's Hospital, Melbourne, Victoria, Australia.

- Breathlessness is common in advanced COPD and remains undertreated .

Cancer

-As all reversible causes of breatlessness are being optimally managed, low dose morphine can reduce safely & effectively breathlessness in patients with severe COPD and refractory dyspnoea.

-Despite numerous guidelines recommending opioids in this clinical setting, many barriers limit their uptake by clinicians .

- Integration of palliative care earlier in the disease course can help to improve symptom control for people with severe COPD and refractory breathlessness.