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Doctors' attitudes towards prescribing opioids for refractory dyspnoea: a single-centred study
Savvas Hadjiphilippou1, Sarah-Elizabeth Odogwu1, Pauline Dand2
1Department of Medicine, Kent and Canterbury Hospital, Canterbury, UK.
UK doctors are willing to prescribe opioids for refractory dyspnoea, but confidence varies by condition. Addressing concerns about side effects and providing clearer guidance is essential for improving opioid use in palliative care.
Area of Science:
- Palliative Care
- Pain Management
- Clinical Pharmacy
Background:
- Dyspnoea is a common and distressing symptom in palliative care.
- Opioids are effective for managing dyspnoea, but their use may be limited by prescriber attitudes.
- Limited data exist on UK hospital doctors' experiences and attitudes towards prescribing opioids for refractory dyspnoea.
Purpose of the Study:
- To explore UK hospital doctors' experience with and attitudes towards prescribing opioids for refractory dyspnoea in advanced disease.
- To identify potential barriers and facilitators to opioid prescribing for dyspnoea relief.
Main Methods:
- Anonymous, semistructured questionnaires were distributed via convenience sampling.
- Data were collected from doctors of all grades attending educational events at a UK district general hospital.
- Descriptive analysis was performed on the collated data.
Main Results:
- Sixty-five questionnaires were analyzed, with most doctors (61/64) willing to prescribe opioids for refractory dyspnoea.
- Confidence in prescribing opioids for dyspnoea was lower than for pain relief.
- Concerns about side effects were prevalent (40/64), and confidence varied by clinical context, being highest for dying patients and lowest for Chronic Obstructive Pulmonary Disease (COPD).
Conclusions:
- UK doctors are aware of and willing to prescribe opioids for refractory dyspnoea.
- Confidence in prescribing varies significantly, particularly concerning side effects.
- Clearer guidance is needed for prescribing opioids for dyspnoea, especially in non-dying patients.
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