Using opioids to treat dyspnea in advanced COPD
Bibliographic record
Abstract
Objective To explore the experiences of family physicians and respiratory therapists in treating advanced chronic obstructive pulmonary disease (COPD) and their attitudes to the use of opioids for dyspnea in this context. Design Qualitative methodology using one-on-one semistructured interviews. Setting Southern New Brunswick (St Stephen to Sussex). Participants Ten family physicians and 8 respiratory therapists who worked in primary care settings. Methods Participant interviews were audiorecorded, transcribed verbatim, coded conceptually, and thematically analyzed using interpretive description. Main findings Participants reported that patients with advanced COPD often suffered from inadequate control of their dyspnea in advanced stages and that they saw the potential value of opioids in this context; however, family physicians described discomfort prescribing opioids. Barriers included insufficient knowledge, lack of education and guidelines, and fear of censure. Those with palliative care experience tended to be more comfortable with opioid prescribing. Conclusion Findings suggest an important need to address barriers related to more effective treatment of refractory dyspnea in advanced COPD. Further, findings indicate these efforts should focus on effective palliation and innovative educational initiatives, as well as the development, promotion, and uptake of evidence-based practice guidelines related to prescribing opioids for these patients.
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How this classification was reachedexpand
Full frame distilled prediction
Teacher imitationNot calibrated prevalence, not ground truth. Human validation pending. Learned from the 10,348 direct Codex labels and 10,348 direct Gemma labels. Candidate is the union of thresholded teacher heads; consensus is their intersection. These outputs are machine_predicted_unvalidated and are not human labels or direct frontier model labels.
Codex and Gemma teacher scores by category
| Category | Codex | Gemma |
|---|---|---|
| Metaresearch | 0.000 | 0.000 |
| Meta-epidemiology (narrow) | 0.000 | 0.000 |
| Meta-epidemiology (broad) | 0.000 | 0.000 |
| Bibliometrics | 0.001 | 0.001 |
| Science and technology studies | 0.000 | 0.000 |
| Scholarly communication | 0.000 | 0.000 |
| Open science | 0.000 | 0.000 |
| Research integrity | 0.000 | 0.000 |
| Insufficient payload (model declined to judge) | 0.000 | 0.000 |
Machine scores (provisional)
The two teacher heads of the student model, read on this work. A score orders the frame for review; it never asserts a category, and the validation status ships verbatim with every row.
Baseline scores from an immature model (maturity gate not passed, 7 training rounds). Scores rank; they never assert a category.
score_only:v0-immature-baseline · verbatim from the scoring run: score_only means the number may rank works, and no category label ships from itClassification
machine, unvalidatedMachine predicted; a candidate call from one teacher head, not a consensus.
How this classification was reached, model by model and score by score, is at the end of the page under "How this classification was reached".