Abstract
Introduction: Dyspnea is a frequent symptom in patients at the end of life, causing intense suffering, although poorly identified. Among pharmacological interventions for dyspnea, opioids, especially morphine, are the most studied and used agents.
Objective: To evaluate the use of morphine to control dyspnea in patients at the end of life in a general hospital and an oncological hospital in Brazil.
Methods: Retrospective cross-sectional study that includes all adult patients selected for palliative care who reported dyspnea at last 24 hours of life and died from July 2018 to December 2018 at Hospital Regional da Asa Norte, Brasília, Distrito Federal, Brazil, and at Hospital Santa Rita, Porto Alegre, Rio Grande do Sul, Brazil. Criteria for end-of-life care were defined according to the Prognostic Indicator Guidance of Gold Standards Framework (PIG-GSF). Deaths that occurred in ICU and operating rooms were excluded.
Results: During the study period, 296 adult patients were selected for palliative care. From these, 230 patients who reported dyspnea in the last 24 hours of life were included (77.7%). Median age was 67.5±14.8 years and the main primary diagnosis was neoplasia (198, 66%). Morphine use was recorded in 168 patients (73.0%) and was more frequent at an oncological hospital than at the general hospital (84.5% vs. 15.5%; p≤0,001).
Conclusions: At the end of life, dyspnea is a prevalent symptom in palliative care patients. Despite its effectiveness in relieving dyspnea and respiratory distress, morphine use is still underused, mainly at the general hospital. Continuous education and training for healthcare professionals may help to improve end-of-life care.
Footnotes
Cite this article as: European Respiratory Journal 2021; 58: Suppl. 65, PA3135.
This abstract was presented at the 2021 ERS International Congress, in session “Prediction of exacerbations in patients with COPD”.
This is an ERS International Congress abstract. No full-text version is available. Further material to accompany this abstract may be available at www.ers-education.org (ERS member access only).
- Copyright ©the authors 2021