Is being able to walk to the letterbox life-changing? A qualitative assessment of measures of improvement in persistent breathlessness

Abstract

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Should opioids be used for breathlessness and in whom? A PRO and CON debate of the evidence

“…The most recent RCT of regular, low-dose ER morphine in COPD, the BEAMS (Breathlessness, Exertion, And Morphine Sulfate) trial, including 156 participants, did not show an improvement in their primary outcome, worst breathlessness after 1 week of treatment, or in other outcomes 19▪▪ . However, an exploratory analysis of qualitative and quantitative data from this study suggested that there are so-called ‘super-responders’ among the participants 26 . These participants described the intervention as life-changing, reported easier breathing, better sleep, improved ability to walk, being able to do meaningful activities, and higher well-being.…”

“…Their quantitative data showed improvement in dyspnea scores, active minutes, and active calories used, which remained after 6 months of morphine use. These findings suggest that meaningful outcomes for patients, such as perceived improvement in meaningful activities and sleep, are not reflected by the traditional outcome measures of currently available RCTs 26 . However, it should be noted that this was a secondary, exploratory analysis without a randomized comparison group.…”