The DOI matches its Crossref record; 25 of the 26 references it cites were found in a registry or an index.
Randomised, double blind, placebo controlled crossover trial of sustained release morphine for the management of refractory dyspnoea
Open accessAbstract
Objective To determine the efficacy of oral morphine in relieving the sensation of breathlessness in patients in whom the underlying aetiology is maximally treated. Design Randomised, double blind, placebo controlled crossover study. Setting Four outpatient clinics at a hospital in South Australia. Participants 48 participants who had not previously been treated with opioids (mean age 76, SD 5) with predominantly chronic obstructive pulmonary disease (42, 88%) were randomised to four days of 20 mg oral morphine with sustained release followed by four days of identically formulated placebo, or vice versa. Laxatives were provided as needed. Main outcome measures Dyspnoea in the morning and evening as shown on a 100 mm visual analogue scale, quality of sleep, wellbeing, performance on physical exertion, and side effects as measured at the end of the four day treatment period. Results 38 participants completed the study; three withdrew because of definite and two because of possible side effects of morphine (nausea, vomiting, and sedation). Participants reported significantly different dyspnoea scores when treated with morphine: an improvement of 6.6 mm (95% confidence interval 1.6 mm to 11.6 mm) in the morning and of 9.5 mm (3.0 mm to 16.1 mm) in the evening (P = 0.011 and P = 0.006, respectively). During the period in which they were taking morphine participants also reported better sleep (P = 0.039). More participants reported distressing constipation while taking morphine (9 v 1, P = 0.021) in spite of using laxatives. All other side effects were not significantly worse with morphine, although the study was not powered to address side effects. Conclusions Sustained release, oral morphine at low dosage provides significant symptomatic improvement in refractory dyspnoea in the community setting.
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 source backs part of the claim, not all of it — or backs it for a different population, condition or comparison.
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 [19]
Experimental — accuracy not yet measured
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
Vestbo, J., Hurd, S. S., Agustí, A. G., Jones, P. W., Vogelmeier, C., Anzueto, A., Barnes, P. J., Fabbri, L. M., Martinez, F. J., Nishimura, M., et al. (2013) · American Journal of Respiratory and Critical Care Medicine · doi:10.1164/rccm.201204-0596pp · Cited by 15,983
Toxicity and response criteria of the Eastern Cooperative Oncology Group
Oken, M. M., Creech, R. H., Tormey, D. C., Horton, J., Davis, T. E., Mcfadden, E. T., & Carbone, P. P. (1982) · American Journal of Clinical Oncology · doi:10.1097/00000421-198212000-00014 · Cited by 11,686
PAUWELS, R. A., Buist, A. S., CALVERLEY, P. M. A., Jenkins, C. R., & Hurd, S. S. (2001) · American Journal of Respiratory and Critical Care Medicine · doi:10.1164/ajrccm.163.5.2101039 · Cited by 6,572
Bestall, J. C., Paul, E. A., Garrod, R., Garnham, R., Jones, P. W., & Wedzicha, J. A. (1999) · Thorax · doi:10.1136/thx.54.7.581 · Cited by 2,927
The two‐period cross‐over clinical trial.
Hills, M., & Armitage, P. (1979) · British Journal of Clinical Pharmacology · doi:10.1111/j.1365-2125.1979.tb05903.x · Cited by 1,399
The Two-Period Change-Over Design and Its Use in Clinical Trials
Grizzle, J. E. (1965) · Biometrics · doi:10.2307/2528104 · Cited by 784
A systematic review of the use of opioids in the management of dyspnoea
Jennings, A.-L. (2002) · Thorax · doi:10.1136/thorax.57.11.939 · Cited by 639
Cancer Patients: Their Desire for Information and Participation in Treatment Decisions
Sutherland, H. J., Llewellyn‐Thomas, H. A., Lockwood, G. A., Tritchler, D., & Till, J. E. (1989) · Journal of the Royal Society of Medicine · doi:10.1177/014107688908200506 · Cited by 435
Dyspnea in Terminally Ill Cancer Patients
Reuben, D. B., & Mor, V. (1986) · CHEST Journal · doi:10.1378/chest.89.2.234 · Cited by 362
Bredin, M., Corner, J. L., Krishnasamy, M., Plant, H., Bailey, C., & A’Hern, R. (1999) · BMJ · doi:10.1136/bmj.318.7188.901 · Cited by 322
Cited by
Sorted by citations
Items 501–522 of 522
(2023) · Elsevier eBooks · doi:10.1016/b978-3-437-23406-4.09983-8
Sitte, T., & Thöns, M. (2023) · Springer eBooks · doi:10.1007/978-3-662-66468-1_5
What Special Considerations Are Needed for Patients With Advanced Lung Disease?
Wagner, C. J., & Iyer, A. S. (2023) · Elsevier eBooks · doi:10.1016/b978-0-323-84702-5.00052-x
A Multimodal Approach to Managing Chronic Breathlessness
Corbett, C. E. (2023) · Springer eBooks · doi:10.1007/978-981-99-4440-8_29
Palliative Care in Advanced Heart Failure
Gadoud, A. (2024) · doi:10.1002/9781119784395.ch17
Lessons about Low-Dose Morphine at the Intersection of Sleep and Breathlessness
Domnik, N. J., & Yaggi, H. K. (2024) · American Journal of Respiratory and Critical Care Medicine · doi:10.1164/rccm.202404-0682ed
Morphine for Chronic Breathlessness
Rohlfing, A., & Widera, E. (2025) · doi:10.1093/med/9780197770337.003.0041
TAVR in older adults with cardiogenic shock: current practice and future direction
Kwak, M. J., Irizarry‐Caro, J. A., Martinez, P. R., Going, J., Lee, J. L., Giza, D. E., Amjad, N., Leech, A. L., Jantea, R., Flores, R. J., et al. (2025) · 老年心脏病学杂志：英文版 · doi:10.26599/1671-5411.2025.05.003
Further research needed before removal of morphine from the therapeutic armoury for breathlessness
Johnson, M. J., Bajwah, S., Chaudhuri, N., Currow, D. C., & Fallon, M. (2025) · The Lancet Respiratory Medicine · doi:10.1016/s2213-2600(25)00389-3
Self-citationNguyen, P., Tran, R., Ko, C., Parikh, S., Cox, R., Li, R., Takashima, D., Hasoon, J. J., & Viswanath, O. (2025) · Springer eBooks · doi:10.1007/978-3-032-07407-2_2
Stratégies ventilatoires en situations palliatives
Venot, M., Kouatchet, A., Jaber, S., Demoule, A., & Azoulay, É. (2015) · Réanimation · doi:10.1007/s13546-015-1023-4
Peverill, R. E. (2005) · The Medical Journal of Australia · doi:10.5694/j.1326-5377.2005.tb07018.x
van Dijk, M., Mooren, K., van den Berg, J.-W. K., van Beurden, W., Heller-Baan, R., de Hosson, S. M., Lam-Wong, W. Y., Peters, L., Pool, K., & Kerstjens, H. A. M. (2021) · Figshare · doi:10.6084/m9.figshare.16606946
Pharmacological Management of Breathlessness
Booth, S., Burkin, J., Moffat, C., & Spathis, A. (2013) · Springer eBooks · doi:10.1007/978-1-4471-4754-1_10
Non-Hypoxic Dyspnea in Terminal Care
Asante, J. O. (2025) · IGI Global eBooks · doi:10.4018/979-8-3373-4099-9.ch004
Douleur et stéatopathie hépatiques, des manifestations systémiques sous estimées de la BPCO
Viglino, D. (2018) · theses.fr (ABES) · doi:10.70675/25ca9b00z8dafz4398zb28azc9e0fd8f6e94
(2026) · Elsevier eBooks · doi:10.1016/b978-3-437-21343-4.00002-5
The experience of family caregivers along the palliative care pathway: a qualitative case study
Severino, M. C., & Rosis, S. D. (2026) · Qualitative Research in Organizations and Management An International Journal · doi:10.1108/qrom-08-2025-3155
Li, D., Yang, Y., Zhang, Y., Yue, J., Dong, B., & Ge, M. (2026) · Journal of Evidence-Based Medicine · doi:10.1111/jebm.70160
Opioids for persistent dyspnoea in people with COPD: should we throw in the towel?
Bourbeau, J., & Currow, D. C. (2026) · European Respiratory Journal · doi:10.1183/13993003.00834-2026
Self-citationFang, L., Tan, Y., & Li, Z. (2026) · Frontiers in Medicine · doi:10.3389/fmed.2026.1881099
Pneumonie – „The old man’s friend“
Skodra, T., & Lorenz, J. (2015) · Der Pneumologe · doi:10.1007/s10405-014-0829-1
Metadata
- Authors
- Abernethy, A. P., Currow, D. C., Frith, P., Fazekas, B. S., McHugh, A., & Bui, C.
- Affiliations
- Flinders University (AU)
- Repatriation General Hospital (AU)
- Nepean Hospital (AU)
- Corresponding author
- Currow, David C
- Venue
- BMJ
- Publisher
- BMJ
- Published
- 2003-09-04
- Volume
- 327
- Issue
- 7414
- Pages
- 523-528
- ISSN
- 0007-1447 (ISSN-L)
- 0959-8138
- 1468-5833
- PMC
- PMC192892
- OpenAlex
- W2157851934
- Cited by
- 521
- References
- 26
- Citations by year
- 2026: 7 · 2025: 10 · 2024: 10 · 2023: 11 · 2022: 17 · 2021: 20 · 2020: 22 · 2019: 19 · 2018: 38 · 2017: 34 · 2016: 38 · 2015: 44 · 2014: 26 · 2013: 25 · 2012: 40
- FWCI
- 11.12
- Type
- journal article
- Language
- en
- Open access
- bronze
- doi.org
- Licence
- www.bmj.com/company/legal-information/terms-conditions/legal-information/tdm-licencepolicy (tdm)
- Locations
- BMJ (publishedVersion)
- Europe PMC (PubMed Central) (publishedVersion)
- PubMed Central (publishedVersion)
- PubMed (publishedVersion)
- Flinders Academic Commons (Flinders University) (submittedVersion)
- Topics
- Health Sciences › Medicine › Pulmonary and Respiratory Medicine › Chronic Obstructive Pulmonary Disease (COPD) Research
- 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
- Keywords
- sustained-release morphine, oral morphine, chronic obstructive pulmonary disease, opioid therapy, dyspnea, sleep quality, constipation, opioid side effects, palliative care, community-based treatment
- MeSH terms
- Administration, Oral, Aged, Chronic Disease, Delayed-Action Preparations, Double-Blind Method, Dyspnea, Female, Humans, Male, Morphine, Narcotics, Cross-Over Studies, Pulmonary Disease, Chronic Obstructive
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
