The impact of regular, low-dose, sustained-release morphine for chronic breathlessness on caregiver burden: An exploratory analysis of the BEAMS trial

Palliat Med. 2024 Jan;38(1):156-162. doi: 10.1177/02692163231211227. Epub 2023 Nov 17.

Abstract

Background: Chronic breathlessness adversely impacts people with chronic obstructive pulmonary disease and their caregivers (family and friends), who may, in turn, experience significant burden due to their caregiving role. Sustained-release morphine may reduce chronic breathlessness in some patients, which may have an impact on caregivers' perceived burden.

Aim: To explore the impact on caregiver burden of active treatment of people with chronic breathlessness (modified Medical Research Council (mMRC) ⩾ 3) and chronic obstructive pulmonary disease (COPD) with regular, low-dose, sustained-release morphine within a multi-site, double-blind, randomised, placebo-controlled trial.

Design: Exploratory analysis of self-reported caregiver burden at baseline and end of week 3 in a randomised, double-blind, placebo-controlled study. Caregiver measures included: demographics and perceived burden (Zarit Burden Interview 12-item short-form questionnaire). Patient measures included: worst breathlessness and FitBitR-measures.

Setting/participants: All consenting caregivers of trial patient participants in a multi-site study recruiting from palliative care and respiratory services.

Results: Caregivers (n = 49; 59% women; median age 68 years [IQR 50-75]) reported median baseline caregiver burden 12 [IQR 5-17], with 53% reporting high burden (⩾13). Eighty-four percent of caregivers reported no change in burden. In people whose worst breathlessness improved, caregiver burden moved in the same direction, though the correlation was not significant (rs = 0.25, p = 0.17). Conversely, caregiver burden worsened as patients' minutes lightly active increased, with the correlation being significant (rs = 0.56, p = 0.04).

Conclusions: Caregivers reported high levels of caregiver burden, but patients' response to treatment in terms of their symptom and function may influence change in caregiver burden over a three-week period.

Keywords: Chronic breathlessness; caregiver burden; chronic obstructive pulmonary disease; randomised controlled trial.

Publication types

  • Multicenter Study
  • Randomized Controlled Trial

MeSH terms

  • Aged
  • Caregiver Burden
  • Caregivers
  • Delayed-Action Preparations / therapeutic use
  • Double-Blind Method
  • Dyspnea / drug therapy
  • Female
  • Humans
  • Male
  • Middle Aged
  • Morphine* / therapeutic use
  • Pulmonary Disease, Chronic Obstructive*

Substances

  • Delayed-Action Preparations
  • Morphine