Breathlessness is the most common symptom in advanced chronic lung disease or chronic heart failure (CHF) [1]. Opioids are recommended for palliative treatment of breathlessness persisting despite optimal pharmacological and non-pharmacological treatment [2, 3]. However, physicians don't always consider opioids for chronic breathlessness [4, 5] and experience barriers when considering opioids, such as resistance of patients [6]. This can limit effective palliative treatment. Qualitative studies in patients with COPD and CHF revealed fear of dependence and fear of imminent death as the most important barriers to opioid use. The reason to start treatment was to do as much as possible [7–9]. These qualitative studies were only conducted in small patient populations. Therefore, our aims were to assess the willingness of patients with chronic lung disease or CHF to use opioids for breathlessness, irrespective of a current indication for opioid treatment; and to assess their barriers towards opioid use and reasons to use opioids. Finally, we aimed to compare willingness differences according to sex, age, educational level, diagnosis and breathlessness severity. Attitudes of patients towards opioid treatment for chronic breathlessness are mixed, with 37% of patients willing to use opioids, 25% unwilling and 38% of patients indecisive. Physicians are an important source of information for these patients. http://bit.ly/2pvNtLJ

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慢性呼吸困难患者对阿片类药物治疗的态度

呼吸困难是晚期慢性肺病或慢性心力衰竭 (CHF) 中最常见的症状 [1]。尽管进行了最佳药物和非药物治疗，但仍建议使用阿片类药物对持续存在的呼吸困难进行姑息治疗 [2, 3]。然而，医生并不总是将阿片类药物用于慢性呼吸困难 [4, 5]，并且在考虑阿片类药物时会遇到障碍，例如患者的抵抗力 [6]。这会限制有效的姑息治疗。对 COPD 和 CHF 患者的定性研究表明，对依赖的恐惧和对即将死亡的恐惧是阿片类药物使用的最重要障碍。开始治疗的原因是尽可能多做 [7-9]。这些定性研究仅在小患者群体中进行。所以，我们的目标是评估慢性肺病或 CHF 患者使用阿片类药物治疗呼吸困难的意愿，而不管当前是否有阿片类药物治疗的指征；并评估他们使用阿片类药物的障碍和使用阿片类药物的原因。最后，我们旨在比较不同性别、年龄、教育水平、诊断和呼吸困难严重程度的意愿差异。患者对阿片类药物治疗慢性呼吸困难的态度参差不齐，37% 的患者愿意使用阿片类药物，25% 的患者不愿意，38% 的患者犹豫不决。医生是这些患者的重要信息来源。http://bit.ly/2pvNtLJ 我们旨在比较不同性别、年龄、教育水平、诊断和呼吸困难严重程度的意愿差异。患者对阿片类药物治疗慢性呼吸困难的态度参差不齐，37% 的患者愿意使用阿片类药物，25% 的患者不愿意，38% 的患者犹豫不决。医生是这些患者的重要信息来源。http://bit.ly/2pvNtLJ 我们旨在比较不同性别、年龄、教育水平、诊断和呼吸困难严重程度的意愿差异。患者对阿片类药物治疗慢性呼吸困难的态度参差不齐，37% 的患者愿意使用阿片类药物，25% 的患者不愿意，38% 的患者犹豫不决。医生是这些患者的重要信息来源。http://bit.ly/2pvNtLJ