The DOI matches its Crossref record; 86 of the 87 references it cites were found in a registry or an index, and 1 are not checked yet.
Opioids for the palliation of refractory breathlessness in adults with advanced disease and terminal illness
Open accessAbstract
BACKGROUND: Breathlessness is a common and disabling symptom which affects many people with advanced cardiorespiratory disease and cancer. The most effective treatments are aimed at treating the underlying disease. However, this may not always be possible, and symptomatic treatment is often required in addition to maximal disease-directed therapy. Opioids are increasingly being used to treat breathlessness, although their mechanism of action is still not completely known. A few good sized, high quality trials have been conducted in this area. OBJECTIVES: To determine the effectiveness of opioid drugs in relieving the symptom of breathlessness in people with advanced disease due to malignancy, respiratory or cardiovascular disease, or receiving palliative care for any other disease. SEARCH METHODS: We performed searches on CENTRAL, MEDLINE, EMBASE, CINAHL, and Web of Science up to 19 October 2015. We handsearched review articles, clinical trial registries, and reference lists of retrieved articles. SELECTION CRITERIA: We included randomised double-blind controlled trials that compared the use of any opioid drug against placebo or any other intervention for the relief of breathlessness. The intervention was any opioid, given by any route, in any dose. DATA COLLECTION AND ANALYSIS: We imported studies identified by the search into a reference manager database. We retrieved the full-text version of relevant studies, and two review authors independently extracted data. The primary outcome measure was breathlessness and secondary outcome measures included exercise tolerance, oxygen saturations, adverse events, and mortality. We analysed all studies together and also performed subgroup analyses, by route of administration, type of opioid administered, and cause of breathlessness. Where appropriate, we performed meta-analysis. We assessed the evidence using the Grading of Recommendations Assessment, Development and Evaluation (GRADE) approach and created three 'Summary of findings' tables. MAIN RESULTS: We included 26 studies with 526 participants. We assessed the studies as being at high or unclear risk of bias overall. We only included randomised controlled trials (RCTs), although the description of randomisation was incomplete in some included studies. We aimed to include double blind RCTs, but two studies were only single blinded. There was inconsistency in the reporting of outcome measures. We analysed the data using a fixed-effect model, and for some outcomes heterogeneity was high. There was a risk of imprecise results due to the low numbers of participants in the included studies. For these reasons we downgraded the quality of the evidence from high to either low or very low.For the primary outcome of breathlessness, the mean change from baseline dyspnoea score was 0.09 points better in the opioids group compared to the placebo group (ranging from a 0.36 point reduction to a 0.19 point increase) (seven RCTs, 117 participants, very low quality evidence). A lower score indicates an improvement in breathlessness. The mean post-treatment dyspnoea score was 0.28 points better in the opioid group compared to the placebo group (ranging from a 0.5 point reduction to a 0.05 point increase) (11 RCTs, 159 participants, low quality evidence).The evidence for the six-minute walk test (6MWT) was conflicting. The total distance in 6MWT was 28 metres (m) better in the opioids group compared to placebo (ranging from 113 m to 58 m) (one RCT, 11 participants, very low quality evidence). However, the change in baseline was 48 m worse in the opioids group (ranging from 36 m to 60 m) (two RCTs, 26 participants, very low quality evidence).The adverse effects reported included drowsiness, nausea and vomiting, and constipation. In those studies, participants were 4.73 times more likely to experience nausea and vomiting compared to placebo, three times more likely to experience constipation, and 2.86 times more likely to experience drowsiness (nine studies, 162 participants, very low quality evidence).Only four studies assessed quality of life, and none demonstrated any significant change. AUTHORS' CONCLUSIONS: There is some low quality evidence that shows benefit for the use of oral or parenteral opioids to palliate breathlessness, although the number of included participants was small. We found no evidence to support the use of nebulised opioids. Further research with larger numbers of participants, using standardised protocols and with quality of life measures included, is needed.
Overview
The claims and statistics of this paper haven’t been checked yet.
Run the check — free, no account needed. It reads the open-access text and checks the sources it cites.
Integrity signals
Registry
Cites
Statistics
Verification
Claims the paper makes
The claims and statistics of this paper haven’t been checked yet.
Run the check — free, no account needed. It reads the open-access text and checks the sources it cites.
Claims other papers make about this one
Each is checked against this paper’s own text: does it say what the citing paper says it does?
The cited source says what the claim attributes to it.
In the citing paper
“Even opioids, with most evidence to support their use, provide benefit of only borderline clinical significance.”
From The Breathing, Thinking, Functioning clinical model: a proposal to facilitate evidence-based breathlessness management in chronic respiratory disease (2017) · cites this paper as [20]
Self-check
Percentages, sums and reported differences re-computed from the paper’s own numbers.
The self-check needs the paper’s full text.
Citations
Cites
5 retracted
Bausewein, C., Booth, S., Gysels, M., & Higginson, I. J. (2013) · Cochrane Database of Systematic Reviews · doi:10.1002/14651858.cd005623.pub3 · Cited by 287
RetractedBausewein, C., Booth, S., Gysels, M., & Higginson, I. J. (2008) · Cochrane Database of Systematic Reviews · doi:10.1002/14651858.cd005623.pub2 · Cited by 210
RetractedOpioids for the palliation of breathlessness in advanced disease and terminal illness.
Jennings, A. L., Davies, A. N., Higgins, J. P. T., Anzures‐Cabrera, J., & Broadley, K. E. (2001) · Cochrane Database of Systematic Reviews · doi:10.1002/14651858.cd002066 · Cited by 190
RetractedOxygen therapy for dyspnoea in adults
Cranston, J. M., Crockett, A. J., & Currow, D. C. (2008) · Cochrane Database of Systematic Reviews · doi:10.1002/14651858.cd004769.pub2 · Cited by 113
RetractedOpioids for the palliation of breathlessness in advanced disease and terminal illness
Jennings, A. L., Davies, A. N., Higgins, J. P. T., Anzures‐Cabrera, J., & Broadley, K. E. (2012) · Cochrane Database of Systematic Reviews · doi:10.1002/14651858.cd002066.pub2 · Cited by 21
RetractedLiberati, A., Altman, D. G., Tetzlaff, J., Mulrow, C., Gøtzsche, P. C., Ioannidis, J. P. A., Clarke, M., Devereaux, P. J., Kleijnen, J., & Moher, D. (2009) · PLoS Medicine · doi:10.1371/journal.pmed.1000100 · Cited by 28,164
Liberati, A., Altman, D. G., Tetzlaff, J., Mulrow, C., Gøtzsche, P. C., Ioannidis, J. P. A., Clarke, M., Devereaux, P. J., Kleijnen, J., & Moher, D. (2009) · Annals of Internal Medicine · doi:10.7326/0003-4819-151-4-200908180-00136 · Cited by 10,349
Meta-analyses involving cross-over trials: methodological issues
Elbourne, D. R., Altman, D. G., Higgins, J. P., Curtin, F., Worthington, H. V., & Vail, A. (2002) · International Journal of Epidemiology · doi:10.1093/ije/31.1.140 · Cited by 2,305
Gluud, L. L., Villumsen, J., & Gluud, C. N. (2001) · Annals of Internal Medicine · doi:10.7326/0003-4819-135-11-200112040-00010 · Cited by 2,266
Parshall, M. B., Schwartzstein, R. M., Adams, L., Banzett, R. B., Manning, H. L., Bourbeau, J., Calverley, P. M., Gift, A. G., Harver, A., Lareau, S. C., et al. (2012) · American Journal of Respiratory and Critical Care Medicine · doi:10.1164/rccm.201111-2042st · Cited by 1,844
Flagged first, then by citations
Research works printed but not linked: 8
- Davis, 1996, Single dose randomised controlled trial of nebulised morphine in patients with cancer related breathlessness, Palliative Medicine, 10, 64-5
- Hui, 2013, Prophylactic subcutaneous fentanyl for exercise-induced breakthrough dyspnea: a preliminary double-blind, randomized controlled trial, Supportive Care in Cancer, 21, S191
- Navigante, 2003, Morphine plus midazolam versus oxygen therapy on severe dyspnea management in the last week of life in hipoxemic advanced cancer patients, Medicina Paliativa, 10, 14
- Thomas, 2010, Methylnaltrexone, a peripheral opioid antagonist for opioid-induced constipation in advanced illness: an analysis of dyspnea in patients with chronic obstructive pulmonary disease (COPD) in two double-blind randomized trials. 18th International Congress on Palliative Care; Oct 5-8, 2010; Montreal, Journal of Palliative Care, 26, 242
- Daubert, 2014, Effect of lorazepam versus morphine on quality of life in hospice patients with dyspnea and anxiety, Journal of the American Pharmacists Association, 54, e193
- Fitzgerald, 1986, Reflex response to chemoreceptor stimulation, 313
- Nattie, 1995, Central chemoreceptors, 473
- The Nordic Cochrane Centre, The Cochrane Collaboration Review Manager (RevMan) 2014
Cited by
Sorted by citations
Henson, L. A., Maddocks, M. M., Evans, C., Davidson, M., Hicks, S., & Higginson, I. J. (2020) · Journal of Clinical Oncology · doi:10.1200/jco.19.00470 · Cited by 381
Dyspnea in COPD: New Mechanistic Insights and Management Implications
O’Donnell, D. E., Milne, K. M., James, M. D., de-Torres, J. P., & Neder, J. A. (2019) · Advances in Therapy · doi:10.1007/s12325-019-01128-9 · Cited by 291
Spathis, A., Booth, S., Moffat, C., Hurst, R., Ryan, R., Chin, C., & Burkin, J. (2017) · npj Primary Care Respiratory Medicine · doi:10.1038/s41533-017-0024-z · Cited by 226
Maddocks, M. M., Lovell, N., Booth, S., Man, W. D., & Higginson, I. J. (2017) · The Lancet · doi:10.1016/s0140-6736(17)32127-x · Cited by 238
Brighton, L. J., Miller, S., Farquhar, M. C., Booth, S., Yi, D., Gao, W., Bajwah, S., Man, W. D., Higginson, I. J., & Maddocks, M. M. (2018) · Thorax · doi:10.1136/thoraxjnl-2018-211589 · Cited by 153
Verberkt, C. A., Everdingen, M. H. J. V. D. B.-V., Schols, J. M. G. A., Hameleers, N., Wouters, E. F. �., & Janssen, D. J. A. (2020) · JAMA Internal Medicine · doi:10.1001/jamainternmed.2020.3134 · Cited by 134
Ahluwalia, S. C., Chen, C. I., Raaen, L. B., Motala, A., Walling, A. M., Chamberlin, M. E., O’Hanlon, C. E., Larkin, J., Lorenz, K., Akinniranye, O., et al. (2018) · Journal of Pain and Symptom Management · doi:10.1016/j.jpainsymman.2018.09.008 · Cited by 130
Management of breathlessness in patients with cancer: ESMO Clinical Practice Guidelines
Hui, D., Maddocks, M. M., Johnson, M. J., Ekström, M. P., Simon, S. T., Ogliari, A. C., Booth, S., & Ripamonti, C. I. (2020) · ESMO Open · doi:10.1136/esmoopen-2020-001038 · Cited by 125
One evidence base; three stories: do opioids relieve chronic breathlessness?
Ekström, M. P., Bajwah, S., Bland, M., Currow, D. C., Hussain, J. A., & Johnson, M. J. (2017) · Thorax · doi:10.1136/thoraxjnl-2016-209868 · Cited by 121
Respiratory adverse effects of opioids for breathlessness: a systematic review and meta-analysis
Verberkt, C. A., Everdingen, M. H. J. V. D. B.-V., Schols, J. M. G. A., Datla, S., Dirksen, C. D., Johnson, M. J., van Kuijk, S. M. J., Wouters, E. F. �., & Janssen, D. J. A. (2017) · European Respiratory Journal · doi:10.1183/13993003.01153-2017 · Cited by 113
Behandlung von erwachsenen Patienten mit ambulant erworbener Pneumonie – Update 2021
Ewig, S., Kolditz, M., Pletz, M. W., Altiner, A., Albrich, W. C., Drömann, D., Flick, H., Gatermann, S. G., Krüger, S., Nehls, W., et al. (2021) · Pneumologie · doi:10.1055/a-1497-0693 · Cited by 98
Recommendations for the Care of Patients Receiving Conservative Kidney Management
Davison, S. N., Tupala, B., Wasylynuk, B. A., Siu, V., Sinnarajah, A., & Triscott, J. A. C. (2019) · Clinical Journal of the American Society of Nephrology · doi:10.2215/cjn.10510917 · Cited by 83
Improving the quality of life of people with advanced respiratory disease and severe breathlessness
Booth, S., & Johnson, M. J. (2019) · Breathe · doi:10.1183/20734735.0200-2019 · Cited by 79
How Medicine Has Changed the End of Life for Patients With Cardiovascular Disease
Warraich, H. J., Hernandez, A. F., & Allen, L. A. (2017) · Journal of the American College of Cardiology · doi:10.1016/j.jacc.2017.07.735 · Cited by 73
Aslakson, R. A., Reinke, L. F., Cox, C. E., Kross, E. K., Benzo, R. P., & Curtis, J. R. (2017) · Journal of Palliative Medicine · doi:10.1089/jpm.2016.0567 · Cited by 68
Jansen, K., Haugen, D. F., Pont, L., & Ruths, S. (2017) · Journal of Pain and Symptom Management · doi:10.1016/j.jpainsymman.2017.06.010 · Cited by 63
Breathlessness services as a new model of support for patients with respiratory disease
Bausewein, C., Schunk, M. V., Schumacher, P., Dittmer, J., Bolzani, A., & Booth, S. (2017) · Chronic Respiratory Disease · doi:10.1177/1479972317721557 · Cited by 60
Management of Dyspnea in the Terminally Ill
Pisani, L., Hill, N. S., Pacilli, A. M. G., Polastri, M., & Nava, S. (2018) · CHEST Journal · doi:10.1016/j.chest.2018.04.003 · Cited by 62
Ambrosino, N., & Fracchia, C. (2019) · Pulmonology · doi:10.1016/j.pulmoe.2019.04.002 · Cited by 67
Palliative care for the patient without cancer
Mounsey, L., Ferres, M., & Eastman, P. (2018) · Australian Journal of General Practice · doi:10.31128/ajgp-07-18-4625 · Cited by 58
Opioids for breathlessness: a narrative review
Johnson, M. J., & Currow, D. C. (2020) · BMJ Supportive & Palliative Care · doi:10.1136/bmjspcare-2020-002314 · Cited by 54
Mackintosh, J. A., Keir, G. J., Troy, L. K., Holland, A. E., Grainge, C., Chambers, D. C., Sandford, D., Jo, H. E., Glaspole, I., WILSHER, M. L., et al. (2024) · Respirology · doi:10.1111/resp.14656 · Cited by 54
Johnson, M. J., Cockayne, S., Currow, D. C., Bell, K. J., Hicks, K., Fairhurst, C. M., Gabe, R., Torgerson, D. J., Jefferson, L., Oxberry, S. G., et al. (2019) · ESC Heart Failure · doi:10.1002/ehf2.12498 · Cited by 48
Hui, D., Kilgore, K. L., Frisbee‐Hume, S. E., Park, M., Liu, D., Balachandran, D. D., & Bruera, E. D. (2017) · Journal of Pain and Symptom Management · doi:10.1016/j.jpainsymman.2017.08.001 · Cited by 47
Prevalence and management of chronic breathlessness in COPD in a tertiary care center
Carette, H., Zysman, M., Morélot‐Panzini, C., Perrin, J., Gómez, E. M., Guillaumot, A., Burgel, P., Deslée, G., Surpas, P., Rouzic, O. L., et al. (2019) · BMC Pulmonary Medicine · doi:10.1186/s12890-019-0851-5 · Cited by 47
Proposals from a French expert panel for respiratory care in ALS patients
Georges, M., Perez, T., Rabec, C. A., Jacquin, L., Monnier, A., Ramos, C., Patout, M., Attali, V., Amador, M. D. M., Gonzalez‐Bermejo, J., et al. (2022) · Respiratory Medicine and Research · doi:10.1016/j.resmer.2022.100901 · Cited by 46
Updates in palliative care – recent advancements in the pharmacological management of symptoms
Star, A., & Boland, J. W. (2018) · Clinical Medicine · doi:10.7861/clinmedicine.18-1-11 · Cited by 45
Care at the Very End-of-Life: Dying Cancer Patients and Their Chosen Family’s Needs
Clark, K. (2017) · Cancers · doi:10.3390/cancers9020011 · Cited by 44
Off-Label Medication Use in the Inpatient Palliative Care Unit
Kwon, J. H., Kim, M. J., Bruera, S., Park, M., Bruera, E. D., & Hui, D. (2017) · Journal of Pain and Symptom Management · doi:10.1016/j.jpainsymman.2017.03.014 · Cited by 43
Palliative care in heart failure
Wiskar, K., Toma, M., & Rush, B. N. M. (2018) · Trends in Cardiovascular Medicine · doi:10.1016/j.tcm.2018.02.008 · Cited by 42
Pharmacologic Interventions for Breathlessness in Patients With Advanced Cancer
Feliciano, J. L., Waldfogel, J. M., Sharma, R., Zhang, A. W., Gupta, A., Sedhom, R., Day, J., Bass, E. B., & Dy, S. M. (2021) · JAMA Network Open · doi:10.1001/jamanetworkopen.2020.37632 · Cited by 42
Lovell, N., Etkind, S. N., Bajwah, S., Maddocks, M. M., & Higginson, I. J. (2018) · Journal of Pain and Symptom Management · doi:10.1016/j.jpainsymman.2018.09.021 · Cited by 40
Nonpharmacological Interventions for Managing Breathlessness in Patients With Advanced Cancer
Gupta, A., Sedhom, R., Sharma, R., Zhang, A., Waldfogel, J. M., Feliciano, J. L., Day, J., Gersten, R. A., Davidson, P. M., Bass, E. B., et al. (2020) · JAMA Oncology · doi:10.1001/jamaoncol.2020.5184 · Cited by 39
Nationwide Survey of Palliative Care for Patients With Heart Failure in Japan
Kuragaichi, T., Kurozumi, Y., Ohishi, S., Sugano, Y., Sakashita, A., Kotooka, N., Suzuki, M., Higo, T., Yumino, D., Takada, Y., et al. (2018) · Circulation Journal · doi:10.1253/circj.cj-17-1305 · Cited by 37
Swetz, K. M., & Kamal, A. H. (2018) · Annals of Internal Medicine · doi:10.7326/aitc201803060 · Cited by 39
Smallwood, N., Currow, D. C., Booth, S., Spathis, A., Irving, L. B., & Philip, J. A. M. (2018) · COPD Journal of Chronic Obstructive Pulmonary Disease · doi:10.1080/15412555.2018.1502264 · Cited by 34
Self-citationOpioid‐induced hypogonadism: Pathophysiology, clinical and therapeutics review
Antony, T., Alzaharani, S. Y., & El-Ghaiesh, S. H. (2019) · Clinical and Experimental Pharmacology and Physiology · doi:10.1111/1440-1681.13246 · Cited by 36
Currow, D. C., Watts, G. J., Johnson, M. J., McDonald, C. F., Miners, J. O., Somogyi, A. A., Denehy, L., McCaffrey, N., Eckert, D. J., McCloud, P., et al. (2017) · BMJ Open · doi:10.1136/bmjopen-2017-018100 · Cited by 33
Quality of Life in Palliative Care: A Systematic Meta-Review of Reviews and Meta-Analyses
Demuro, M., Bratzu, E., Lorrai, S., & Preti, A. (2024) · Clinical Practice and Epidemiology in Mental Health · doi:10.2174/0117450179183857240226094258 · Cited by 31
Symptoms During Outpatient Cancer Treatment and Options for their Management
Tewes, M., Baumann, F. T., Teufel, M., & Ostgathe, C. (2021) · Deutsches Ärzteblatt international · doi:10.3238/arztebl.m2021.0028 · Cited by 31
Palliative Care for Cancer Patients During the COVID-19 Pandemic, With Special Focus on Lung Cancer
Schoenmaekers, J. J. A. O., Hendriks, L. E. L., & Everdingen, M. H. J. V. D. B.-V. (2020) · Frontiers in Oncology · doi:10.3389/fonc.2020.01405 · Cited by 28
Smallwood, N., Pascoe, A., Wijsenbeek, M. S., Russell, A., Holland, A. E., Romero, L., & Ekström, M. P. (2024) · European Respiratory Review · doi:10.1183/16000617.0265-2023 · Cited by 27
Self-citationManagement of COPD in End-of-Life Care by Spanish Pulmonologists
Ecenarro, P. S., Inchausti, M., Tejada, S. P., Malanda, N. M., Imizcoz, M. A., Marlasca, L. A., & Navarrete, B. A. (2018) · COPD Journal of Chronic Obstructive Pulmonary Disease · doi:10.1080/15412555.2018.1441274 · Cited by 27
Palliative care in the context of a pandemic: similar but different
Davies, A. N., & Hayes, J. (2020) · Clinical Medicine · doi:10.7861/clinmed.2020-0157 · Cited by 27
Sensory interventions to relieve dyspnoea in critically ill mechanically ventilated patients
Bureau, C., Nierat, M., Decavèle, M., Rivals, I., Dangers, L., Beurton, A., Virolle, S., Déléris, R., Delemazure, J., Mayaux, J., et al. (2023) · European Respiratory Journal · doi:10.1183/13993003.02215-2022 · Cited by 26
Symptom management challenges in heart failure: pharmacotherapy considerations
Stewart, D., & McPherson, M. L. (2017) · Heart Failure Reviews · doi:10.1007/s10741-017-9632-5 · Cited by 26
Luo, N., Tan, S., Li, X., Singh, S., Liu, S., Chen, C., Zhuang-zhi, H., Feng, S., Lin, Y., Lin, Y., et al. (2020) · Journal of Pain and Symptom Management · doi:10.1016/j.jpainsymman.2020.07.021 · Cited by 26
Fu, Y., Chapman, E., Boland, A. C., & Bennett, M. (2022) · Palliative Medicine · doi:10.1177/02692163221079697 · Cited by 27
Higginson, I. J., Brown, S. T., Oluyase, A. O., May, P., Maddocks, M. M., Costantini, M., Bajwah, S., Normand, C. E. M., Bausewein, C., Simon, S. T., et al. (2024) · The Lancet Respiratory Medicine · doi:10.1016/s2213-2600(24)00187-5 · Cited by 25
Heart Failure in Older Patients: An Update
Montalto, M., D’Ignazio, F., Camilli, S., Francesco, S. D., Fedele, M., Landi, F., & Gallo, A. (2025) · Journal of Clinical Medicine · doi:10.3390/jcm14061982 · Cited by 27
Spathis, A., Burkin, J., Moffat, C., Tuffnell, R., Barclay, S. I. G., Mant, J., & Booth, S. (2021) · npj Primary Care Respiratory Medicine · doi:10.1038/s41533-021-00237-9 · Cited by 24
Dubé, B., Vermeulen, F., & Laveneziana, P. (2016) · Archivos de Bronconeumología · doi:10.1016/j.arbres.2016.09.005 · Cited by 24
Indian Guidelines on Nebulization Therapy
Katiyar, S. K., Gaur, S. N., Solanki, R., Sarangdhar, N., Suri, J. C., Kumar, R., Khilnani, G., Chaudhary, D., Singla, R., Koul, P. A., et al. (2022) · Indian Journal of Tuberculosis · doi:10.1016/j.ijtb.2022.06.004 · Cited by 23
Mori, M., Yamaguchi, T., Matsuda, Y., Suzuki, K., Watanabe, H., Matsunuma, R., Kako, J., Imai, K., Usui, Y., Matsumoto, Y., et al. (2020) · ESMO Open · doi:10.1136/esmoopen-2019-000603 · Cited by 23
Yamaguchi, T., Matsunuma, R., Suzuki, K., Matsuda, Y., Mori, M., & Watanabe, H. (2019) · Journal of Pain and Symptom Management · doi:10.1016/j.jpainsymman.2019.06.006 · Cited by 22
Maddocks, M. M., Brighton, L. J., Farquhar, M. C., Booth, S., Miller, S., Klass, L., Tunnard, I., Yi, D., Gao, W., Bajwah, S., et al. (2019) · Health Services and Delivery Research · doi:10.3310/hsdr07220 · Cited by 22
Caron, M., Parrot, A., Elabbadi, A., Dupeyrat, S., Turpin, M., Baury, T., Rozencwajg, S., Blayau, C., Fulgencio, J.-P., Gibelin, A., et al. (2021) · Annals of Intensive Care · doi:10.1186/s13613-021-00832-6 · Cited by 21
Mirtazapine for chronic breathlessness? A review of mechanistic insights and therapeutic potential
Lovell, N., Wilcock, A., Bajwah, S., Etkind, S. N., Jolley, C. J., Maddocks, M. M., & Higginson, I. J. (2018) · Expert Review of Respiratory Medicine · doi:10.1080/17476348.2019.1563486 · Cited by 23
Le, T. T., Park, S., Choi, M. E., Wijesinha, M. A., Khokhar, B., & Simoni, J. M. (2020) · BMJ Open Respiratory Research · doi:10.1136/bmjresp-2019-000483 · Cited by 21
Use of short-acting opioids in the management of breathlessness: an evidence-based review
Hui, D., & Bruera, E. D. (2020) · Current Opinion in Supportive and Palliative Care · doi:10.1097/spc.0000000000000509 · Cited by 20
Vicent, L., Olarte, J. M. N., Puente‐Maestu, L., Oliva, A., López‐Azor, J. C., Postigo, A., de Miguel, I. M., Luna‐López, R., Fernández‐Avilés, F., & Martínez‐Sellés, M. (2017) · BMC Palliative Care · doi:10.1186/s12904-017-0208-x · Cited by 20
Johnston, K., Young, M., Kay, D., Booth, S., Spathis, A., & Williams, M. (2020) · BMC Medical Education · doi:10.1186/s12909-020-02006-7 · Cited by 19
Interventions for palliative symptom control in COVID-19 patients
Andreas, M., Piechotta, V., Skoetz, N., Grummich, K., Becker, M., Joos, L., Becker, G., Meißner, W., & Boehlke, C. S. (2021) · Cochrane Database of Systematic Reviews · doi:10.1002/14651858.cd015061 · Cited by 19
Malignant Pleural Effusion: A Multidisciplinary Approach
Pardessus, A., Rafecas, A., Porcel, J. M., Serra, P., Ferreiro, L., Botana‐Rial, M., Hernández, C. R., Brenes, J. M., Canales, L., Camacho, V., et al. (2024) · Open Respiratory Archives · doi:10.1016/j.opresp.2024.100349 · Cited by 18
Standardized measurement of breathlessness during exercise
Lewthwaite, H., Koch, E. M., Tracey, L., & Jensen, D. (2019) · Current Opinion in Supportive and Palliative Care · doi:10.1097/spc.0000000000000443 · Cited by 18
Smallwood, N., Gaffney, N., Gorelik, A., Irving, L. B., Le, B. H. C., & Philip, J. A. M. (2017) · Internal Medicine Journal · doi:10.1111/imj.13521 · Cited by 17
Self-citationFentanyl treatment for end-of-life dyspnoea relief in advanced cancer patients
Benítez-Rosario, M. Á., Rosa-González, I., González‐Dávila, E., & Sanz, E. J. (2018) · Supportive Care in Cancer · doi:10.1007/s00520-018-4309-8 · Cited by 17
Palliative Care in Lung Cancer
Aragon, K. (2020) · Clinics in Chest Medicine · doi:10.1016/j.ccm.2020.02.005 · Cited by 17
Application of palliative ventilation: potential and clinical evidence in palliative care
Mercadante, S., Giarratano, A., Cortegiani, A., & Gregoretti, C. (2017) · Supportive Care in Cancer · doi:10.1007/s00520-017-3710-z · Cited by 17
Waskiw‐Ford, M., Wu, A., Mainra, A., Marchand, N. H., Alhuzaim, A., Bourbeau, J., Smith, B. M., & Jensen, D. (2018) · Frontiers in Physiology · doi:10.3389/fphys.2018.00086 · Cited by 16
Krajnik, M., Hepgul, N., Wilcock, A., Jassem, E., Bandurski, T., Tanzi, S., Simon, S. T., Higginson, I. J., Jolley, C. J., Nowakowska-Arendt, A., et al. (2022) · BMC Pulmonary Medicine · doi:10.1186/s12890-022-01835-0 · Cited by 16
Exertional Dyspnoea in Chronic Respiratory Diseases: From Physiology to Clinical Application
Dubé, B., Vermeulen, F., & Laveneziana, P. (2016) · Archivos de Bronconeumología · doi:10.1016/j.arbr.2016.11.003 · Cited by 16
Palliative Care in Lung Cancer: When to Start
Bhattacharya, P., Dessain, S. K., & Evans, T. L. (2018) · Current Oncology Reports · doi:10.1007/s11912-018-0731-9 · Cited by 16
Azhar, A., & Hui, D. (2022) · Cancer Research and Treatment · doi:10.4143/crt.2022.143 · Cited by 15
Neder, J. A., & O’Donnell, D. E. (2020) · Current Opinion in Supportive and Palliative Care · doi:10.1097/spc.0000000000000516 · Cited by 17
Palliation, end of life care and ventilation withdrawal in neuromuscular disorders
Elverson, J., Evans, H., & Dewhurst, F. (2023) · Chronic Respiratory Disease · doi:10.1177/14799731231175911 · Cited by 15
[Integral approach to the acute exacerbation of chronic obstructive pulmonary disease].
del Castillo, J. M. G., Candel, F. J., de la Fuente, J., Gordo, F., Martín‐Sánchez, F. J., Menéndez, R., Mujal, A., & Barberán, J. (2018) · Europe PMC (PubMed Central) · Cited by 15
Lovell, N., Etkind, S. N., Bajwah, S., Maddocks, M. M., & Higginson, I. J. (2019) · Journal of Pain and Symptom Management · doi:10.1016/j.jpainsymman.2019.06.004 · Cited by 14
Treatment of Dyspnea in Advanced Disease and at the End of Life
Campbell, M., Donesky, D., Sarkozy, A., & Reinke, L. F. (2021) · Journal of Hospice and Palliative Nursing · doi:10.1097/njh.0000000000000766 · Cited by 14
Opioids for the management of dyspnea in cancer patients: a systematic review and meta-analysis
Takagi, Y., Sato, J., Yamamoto, Y., Matsunuma, R., Watanabe, H., Mori, M., Hasegawa, T., Matsuda, Y., Kako, J., Kasahara, Y., et al. (2023) · International Journal of Clinical Oncology · doi:10.1007/s10147-023-02362-6 · Cited by 14
Palliative care and interstitial lung disease
Bajwah, S., & Yorke, J. (2017) · Current Opinion in Supportive and Palliative Care · doi:10.1097/spc.0000000000000285 · Cited by 14
Takahashi, K., Kondo, M., Ando, M., Shiraki, A., Nakashima, H., Wakayama, H., Kataoka, K., Yamamoto, M., Sugino, Y., Nishikawa, M., et al. (2019) · The Oncologist · doi:10.1634/theoncologist.2018-0468 · Cited by 14
Mori, M., Yamaguchi, T., Suzuki, K., Matsuda, Y., Matsunuma, R., Watanabe, H., Ikari, T., Matsumoto, Y., Imai, K., Yokomichi, N., et al. (2022) · Cancer Medicine · doi:10.1002/cam4.5362 · Cited by 13
Off-label use in adult palliative care – more common than expected. A retrospective chart review
Hagemann, V., Bausewein, C., & Rémi, C. (2021) · European Journal of Hospital Pharmacy · doi:10.1136/ejhpharm-2020-002554 · Cited by 13
Mori, M., Kawaguchi, T., Imai, K., Yokomichi, N., Yamaguchi, T., Suzuki, K., Matsunuma, R., Watanabe, H., Maeda, I., Matsumoto, Y., et al. (2021) · Journal of Pain and Symptom Management · doi:10.1016/j.jpainsymman.2021.05.001 · Cited by 13
Palliativversorgung von Menschen mit fortgeschrittener Demenz
Diehl‐Schmid, J., Riedl, L., Rüsing, U., Hartmann, J., Bertok, M., Levin, C., Hamann, J., Arcand, M., Lorenzl, S., Feddersen, B., et al. (2018) · Der Nervenarzt · doi:10.1007/s00115-017-0468-y · Cited by 13
Howell, D. (2021) · Lung Cancer Management · doi:10.2217/lmt-2020-0017 · Cited by 12
Binks, A. P. (2022) · Handbook of clinical neurology · doi:10.1016/b978-0-323-91534-2.00008-4 · Cited by 13
Should opioids be used for breathlessness and in whom? A PRO and CON debate of the evidence
Ekström, M. P., & Janssen, D. J. A. (2023) · Current Opinion in Supportive and Palliative Care · doi:10.1097/spc.0000000000000674 · Cited by 12
Vozoris, N. T. (2020) · Annals of Palliative Medicine · doi:10.21037/apm.2019.11.04 · Cited by 12
Inspiratory neural drive and dyspnea in interstitial lung disease: Effect of inhaled fentanyl
Milne, K. M., Masthan, M. I., Scheeren, R. E., James, M. D., Phillips, D. B., Moran‐Mendoza, O., Neder, J. A., & O’Donnell, D. E. (2020) · Respiratory Physiology & Neurobiology · doi:10.1016/j.resp.2020.103511 · Cited by 12
European Respiratory Society Monograph
Jensen, D., Pattinson, K., & Jolley, C. (2016) · European Respiratory Society eBooks · doi:10.1183/2312508x.10011715 · Cited by 12
Schloesser, K., Bergmann, A., Eisenmann, Y., Pauli, B., Hellmich, M., Oberste, M., Hamacher, S., Tuchscherer, A., Frank, K. F., Randerath, W. J., et al. (2021) · Journal of Pain and Symptom Management · doi:10.1016/j.jpainsymman.2021.11.003 · Cited by 11
Episodic Breathlessness in Patients with Advanced Cancer: Characteristics and Management
Mercadante, S. (2018) · Drugs · doi:10.1007/s40265-018-0879-5 · Cited by 11
Integrated breathlessness services for people with chronic conditions
Bausewein, C., Schumacher, P., & Bolzani, A. (2018) · Current Opinion in Supportive and Palliative Care · doi:10.1097/spc.0000000000000361 · Cited by 10
Morphine for chronic breathlessness in COPD: improvement predictors-cross-sectional study
Verberkt, C. A., Everdingen, M. H. J. V. D. B.-V., Schols, J. M. G. A., Wouters, E. F. �., & Janssen, D. J. A. (2022) · BMJ Supportive & Palliative Care · doi:10.1136/spcare-2022-003693 · Cited by 10
Updates in opioid and nonopioid treatment for chronic breathlessness
Abdallah, S. J., Jensen, D., & Lewthwaite, H. (2019) · Current Opinion in Supportive and Palliative Care · doi:10.1097/spc.0000000000000449 · Cited by 10
Symptomatic treatment of dyspnea in advanced cancer patients
Strieder, M., Pecherstorfer, M., & Kreye, G. (2017) · Wiener Medizinische Wochenschrift · doi:10.1007/s10354-017-0600-4 · Cited by 10
Palliative care in gynecologic oncology
Karlin, D. M., Phung, P. G., & Pietras, C. J. (2017) · Current Opinion in Obstetrics & Gynecology · doi:10.1097/gco.0000000000000426 · Cited by 10
Mottiar, M., Hendin, A., Fischer, L. M., Ordons, A. R. D., & Hartwick, M. (2020) · Canadian Journal of Anesthesia/Journal canadien d anesthésie · doi:10.1007/s12630-020-01699-0 · Cited by 12
Metadata
- Authors
- Barnes, H., McDonald, J., Smallwood, N., & Manser, R.
- Affiliations
- The Alfred Hospital (AU)
- University Health Network (CA)
- The Royal Melbourne Hospital (AU)
- and Department of Respiratory Medicine, Royal Melbourne Hospital; Department of Haematology and Medical Oncology, Peter MacCallum Cancer Institute, St Andrew's Place, East Melbourne 3002, Victoria; 305 Grattan Street Melbourne Australia 3000
- Venue
- Cochrane Database of Systematic Reviews
- Publisher
- Wiley
- Published
- 2016-03-31
- Volume
- 2019
- Issue
- 7
- Pages
- CD011008-CD011008
- ISSN
- 1361-6137 (ISSN-L)
- 1465-1858
- PMC
- PMC6485401
- OpenAlex
- W1598113675
- Cited by
- 280
- References
- 86
- Citations by year
- 2026: 8 · 2025: 17 · 2024: 19 · 2023: 26 · 2022: 24 · 2021: 43 · 2020: 31 · 2019: 31 · 2018: 31 · 2017: 37 · 2016: 10
- FWCI
- 6.80
- Type
- journal article
- Language
- en
- Open access
- bronze
- doi.org
- Locations
- Cochrane Database of Systematic Reviews (publishedVersion)
- PubMed Central (publishedVersion)
- PubMed (publishedVersion)
- Funders
- National Institute for Health and Care Research
- Evidence Synthesis Programme
- Topics
- Health Sciences › Medicine › Anesthesiology and Pain Medicine › Pain Management and Opioid Use
- Health Sciences › Medicine › Public Health, Environmental and Occupational Health › Palliative Care and End-of-Life Issues
- Health Sciences › Medicine › Public Health, Environmental and Occupational Health › Palliative and Oncologic Care
- Keywords
- opioids, dyspnea, palliative care, advanced disease, terminal illness, cancer, cardiopulmonary disease, symptom management, route of administration, exercise tolerance, oxygen saturation, adverse events, mortality, opioid analgesics, opioid agonists, opioid antagonists, opioid side effects, opioid use disorder, opioid withdrawal
- MeSH terms
- Adult, Analgesics, Opioid, Dyspnea, Humans, Morphine, Palliative Care, Quality of Life, Terminal Care, Time Factors, Randomized Controlled Trials as Topic, Walking, Exercise Tolerance
About these checks
Registry, retraction, Cites and statistics results are computed, not judged, with one exception: a printed reference that no index lists is read once by a model before it counts as a citation error. Claims are extracted by a model and kept only when their quote appears verbatim in the text; each cited source is then checked, with a model’s help, for whether it says what the claim relies on. Those verdicts can be wrong — read the claim’s quote and the cited source before relying on one.
Statistics and arithmetic are recomputed, not judged.
Confidence bands are shown only for fields calibrated on our annotated test set. None is calibrated yet, so no band is shown.
What counts as a claim ›How we measure confidence ›How we check this ›
Are you an author, or do you see a problem with this page? Request a review
