TY - JOUR T1 - Using opioids to treat dyspnea in advanced COPD JF - Canadian Family Physician JO - Can Fam Physician SP - e401 LP - e407 VL - 58 IS - 7 AU - Joanne Young AU - Margaret Donahue AU - Morag Farquhar AU - Cathy Simpson AU - Graeme Rocker Y1 - 2012/07/01 UR - http://www.cfp.ca/content/58/7/e401.abstract N2 - Objective To explore the experiences of family physicians and respiratory therapists in treating advanced chronic obstructive pulmonary disease (COPD) and their attitudes to the use of opioids for dyspnea in this context. Design Qualitative methodology using one-on-one semistructured interviews. Setting Southern New Brunswick (St Stephen to Sussex). Participants Ten family physicians and 8 respiratory therapists who worked in primary care settings. Methods Participant interviews were audiorecorded, transcribed verbatim, coded conceptually, and thematically analyzed using interpretive description. Main findings Participants reported that patients with advanced COPD often suffered from inadequate control of their dyspnea in advanced stages and that they saw the potential value of opioids in this context; however, family physicians described discomfort prescribing opioids. Barriers included insufficient knowledge, lack of education and guidelines, and fear of censure. Those with palliative care experience tended to be more comfortable with opioid prescribing. Conclusion Findings suggest an important need to address barriers related to more effective treatment of refractory dyspnea in advanced COPD. Further, findings indicate these efforts should focus on effective palliation and innovative educational initiatives, as well as the development, promotion, and uptake of evidence-based practice guidelines related to prescribing opioids for these patients. ER -