Junior doctors may be a little too enthusiastic about the use of opioids for the management of refractory breathlessness in patients with COPD.
According to a survey of basic trainees in Victoria, most (87%) believed that opioids have a role in the management of breathlessness and 64% would recommend it as a first line treatment.
Almost half (46%) said they had prescribed an opioid for this indication under supervision and 25% said they had initiated opioid treatment themselves.
More than one quarter (26%) of the doctors said they had no concerns prescribing an opioid for COPD patients.
The results suggest a generational change in attitudes given well-documented reluctance by doctors to prescribe opioid treatment despite the evidence base for its use.
Melbourne respiratory physician and co-author Dr Natasha Smallwood told the limbic there might be some ‘bravado’ involved with so many junior doctors reporting they had initiated opioid treatment themselves.
“Perhaps it means that senior physicians are actually coming on board and the confidence of junior doctors is mirroring a change in practice of senior general and respiratory physicians.”
She said it was exciting that junior doctors were recognising that there were additional options for symptom control beyond optimal management of the patients’ disease.