Dyspnea is the most frequently reported symptom of outpatients with advanced
chronic obstructive pulmonary disease (
COPD).
Opioids are an effective treatment for
dyspnea. Nevertheless, the prescription of
opioids to patients with advanced
COPD seems limited. The aims of this study are to explore the attitudes of Dutch chest physicians toward prescription of
opioids for refractory
dyspnea to outpatients with advanced
COPD and to investigate the barriers experienced by chest physicians toward
opioid prescription in these patients. All chest physicians (n = 492) and residents in respiratory medicine (n = 158) in the Netherlands were invited by e-mail to complete an online survey. A total of 146 physicians (response rate 22.5%) completed the online survey. Fifty percent of the physicians reported to prescribe
opioids for refractory
dyspnea in 20% or less of their outpatients with advanced
COPD and 18.5% reported never to prescribe
opioids in these patients. The most frequently reported barriers toward prescription of
opioids were resistance of the patient, fear of possible adverse effects, and fear of
respiratory depression. To conclude, Dutch chest physicians and residents in respiratory medicine rarely prescribe
opioids for refractory
dyspnea to outpatients with advanced
COPD. This reluctance is caused by perceived resistance of the patient and fear of adverse effects, including respiratory adverse effects.