%0 Journal Article %A Natasha Smallwood %A David Currow %A Sara Booth %A Anna Spathis %A Louis Irving %A Jennifer Philip %T Physicians' attitudes to dyspnoea management in advanced chronic obstructive pulmonary disease (COPD) %D 2016 %R 10.1183/13993003.congress-2016.PA3748 %J European Respiratory Journal %P PA3748 %V 48 %N suppl 60 %X Refractory breathlessness is common and undertreated in patients with advanced COPD. Dyspnoea management is often complex and may include opioids, however there is a perceived reluctance to utilise this treatment option.Aims: To examine physicians' attitudes to dyspnoea management for COPD patients.Methods: 2161 specialists and registrars in respiratory medicine (RM) (n=940) and palliative medicine (PM) (n=1221) in Australia, New Zealand and the UK were invited by email to complete an on-line, case-vignette based survey.Results: Overall response rate 27% (n=574) and 446 completed dyspnoea management questions.Respiratory Medicine n=183 (20%)Palliative Medicine n=263 (22%)Male116 (63%)71 (27%)Years in specialty practice (median)1312Australia156 (85%)98 (37%)New Zealand27 (15%)31 (12%)UK0134 (51%)Uses dyspnoea score routinely59 (32%)47 (18%)Add dyspnoea medication127 (69%)239 (91%)Recommended treatment for refractory dyspnoeaShort acting morphine 2.5-5mg 4-6hrly PRN74 (58%)197 (82%)Long acting morphine 10-20mg/24hrs20 (16%)15 (6%)Low dose benzodiazepine*15 (12%)6 (3%)*e.g. Lorazepam 0.5mg BD or PRNIn a stable optimally managed COPD patient, 115 (63%) RM physicians and 220 (84%) PM physicians recommended adding a medication for refractory dyspnoea. A further 12 (7%) RM physicians and 19 (7%) PM physicians would consider this option.In practice, only 65 (36%) RM physicians, compared with 213 (81%) PM physicians reported regularly prescribing opioids for COPD patients with refractory breathlessness.Conclusions: While physicians recognised the role of opioids for refractory dyspnoea in COPD, this was not part of routine dyspnoea management for RM physicians. %U