Morphine for chronic breathlessness in COPD: improvement predictors-cross-sectional study

Area of Science:

• Pulmonary Medicine
• Palliative Care
• Pharmacology

Background:

• Chronic breathlessness is a debilitating symptom in Chronic Obstructive Pulmonary Disease (COPD).
• Morphine is utilized for palliative care in COPD patients with chronic breathlessness.
• A subset of patients does not achieve clinically meaningful relief from breathlessness with morphine treatment.

Purpose of the Study:

• To identify patient characteristics associated with clinically meaningful improvement in breathlessness after morphine treatment.
• To investigate the relationship between sensory breathlessness descriptors, demographic, and clinical factors and treatment response.
• To guide the selection of COPD patients who may benefit most from opioid therapy for breathlessness.

Main Methods:

• Secondary analysis of a randomized controlled trial intervention arm.
• Included 45 COPD patients with moderate-to-very severe chronic breathlessness.
• Assessed baseline breathlessness, sensory descriptors, age, and BMI using binary logistic regression.

Main Results:

• 42% of participants (21/45) experienced a clinically meaningful improvement in breathlessness.
• Higher baseline breathlessness (OR 1.51) and higher Body Mass Index (BMI) (OR 1.13) were significantly associated with improvement.
• Age and sensory breathlessness descriptors were not significantly associated with improved breathlessness.

Conclusions:

• Worse baseline breathlessness and higher BMI predict a positive response to oral sustained-release morphine in COPD patients.
• Morphine treatment for severe breathlessness in COPD is supported, with consideration for patient BMI.
• These findings can help personalize palliative care strategies for breathlessness in COPD.