Kochovska Slavica, Ferreira Diana, Chang Sungwon, Luckett Tim, Roydhouse Jessica, Ekström Magnus, Currow David C
Faculty of Science, Medicine and Health, University of Wollongong, Wollongong, NSW, Australia.
IMPACCT, Faculty of Health, University of Technology Sydney, Sydney, NSW, Australia.
Palliat Med. 2024 Jan;38(1):156-162. doi: 10.1177/02692163231211227. Epub 2023 Nov 17.
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.
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.
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: breathlessness and FitBit-measures.
SETTING/PARTICIPANTS: All consenting caregivers of trial patient participants in a multi-site study recruiting from palliative care and respiratory services.
Caregivers ( = 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 improved, caregiver burden moved in the same direction, though the correlation was not significant ( = 0.25, = 0.17). Conversely, caregiver burden worsened as patients' increased, with the correlation being significant ( = 0.56, = 0.04).
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.
慢性呼吸急促对慢性阻塞性肺疾病患者及其照顾者（家人和朋友）产生不利影响，而照顾者可能因照顾角色而承受巨大负担。缓释吗啡可能会减轻部分患者的慢性呼吸急促症状，这可能会对照顾者感受到的负担产生影响。
在一项多中心、双盲、随机、安慰剂对照试验中，探讨使用常规低剂量缓释吗啡积极治疗慢性呼吸急促（改良医学研究委员会（mMRC）评分⩾3）和慢性阻塞性肺疾病（COPD）患者对照顾者负担的影响。
在一项随机、双盲、安慰剂对照研究中，对基线和第3周结束时自我报告的照顾者负担进行探索性分析。照顾者的测量指标包括：人口统计学特征和感受到的负担（ Zarit负担访谈12项简表问卷）。患者的测量指标包括：呼吸急促和FitBit测量数据。
设置/参与者：从姑息治疗和呼吸服务机构招募的多中心研究中，所有同意参与试验的患者的照顾者。
照顾者（n = 49；59%为女性；年龄中位数68岁[四分位间距50 - 75]）报告的基线照顾者负担中位数为12[四分位间距5 - 17]，53%的人报告负担较重（⩾13）。84%的照顾者报告负担没有变化。在病情改善的患者中，照顾者负担朝着相同方向变化，尽管相关性不显著（r = 0.25，P = 0.17）。相反，随着患者病情加重，照顾者负担加重，相关性显著（r = 0.56，P = 0.04）。
照顾者报告的照顾者负担水平较高，但患者在症状和功能方面对治疗的反应可能会在三周内影响照顾者负担的变化。
