One evidence base; three stories: do opioids relieve chronic breathlessness?

Research output: Contribution to journalLetter


The efficacy of low-dose systemic opioids for chronic breathlessness was questioned by the recent Cochrane review by Barnes et al We examined the reasons for this conflicting finding and re-evaluated the efficacy of systemic opioids. Compared with previous meta-analyses, Barnes et al reported a smaller effect and lower precision, but did not account for matched data of crossover trials (11/12 included trials) and added a risk-of-bias criterion (sample size). When re-analysed to account for crossover data, opioids decreased breathlessness (standardised mean differences -0.32; -0.18 to -0.47; I2=44.8%) representing a clinically meaningful reduction of 0.8 points (0-10 numerical rating scale), consistent across meta-analyses.


  • Magnus Ekström
  • Sabrina Bajwah
  • J. Martin Bland
  • David C. Currow
  • Jamilla Hussain
  • Miriam J. Johnson
External organisations
  • King's College London
  • University of York
  • Flinders University
  • Hull York Medical School
Research areas and keywords

Subject classification (UKÄ) – MANDATORY

  • Biomedical Laboratory Science/Technology
  • Public Health, Global Health, Social Medicine and Epidemiology


  • COPD Pharmacology, Palliative Care, Perception of Asthma/Breathlessness
Original languageEnglish
Pages (from-to)88-90
Number of pages3
Issue number1
Publication statusPublished - 2018
Publication categoryResearch