Ann Robinson’s research reviews—8 December 2022

A bout de souffleMy mum was a smoker, and watching her struggle to breathe as chronic obstructive pulmonary disease (COPD) took hold was heartbreaking. When your main activity of daily living is breathing, it doesn’t leave much physical or psychological strength for anything else. The treatment options are limited and increasingly ineffective as the condition progresses. Low dose opioids are commonly tried for symptom control, but evidence is sparse. A small but notable Australian trial of 156 people with COPD and chronic breathlessness (MRC modified breathlessness scale score 3 or 4) found that a week of daily, low dose, oral, extended release morphine (8 or 16 mg/day) didn’t significantly improve the intensity of worst breathlessness compared with placebo. The daily step count didn’t improve either, even at higher doses of up to 48 mg/day. More people who received morphine had serious adverse events such as increased breathlessness, morphine related symptoms,…
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