Rationale: Chronic respiratory diseases (CRDs) are often associated with breathlessness despite optimal specific treatment. Opioids may cause respiratory depression and even premature death, but some trials provided data on their safety and benefit. We hypothesized that the use of opioids would vary according to the underlying respiratory disease, its severity and its type and aimed to address this hypothesis with the use of clinical cases.

Methods: Different clinical cases were designed: we present those with lung cancer (LC), COPD, or ILD. All clinical cases described a patient at an early stage of the disease, at a more advanced stage with pre-terminal disease and during an acute exacerbation.  Responders were asked to answer to one clinical case according to their area of expertise. Data were collected from Sept. to Dec. 2022

Results: The 183 physicians responded. On a Likert scale from 0 to 5 (not at all ? very confident), knowledge about breathlessness and ability to relieve it were scored ?3 by 84% and 80% respectively.
Opioid prescription varied according to disease type and severity (Table 1), but not of age and education. 70% of responders began it with outpatient against 30% during hospitalization.

Conclusion: This survey shows important discrepancies in habits of opioid prescription, depending on CRD etiology and severity.

Table1: Proportion of opioid use for breathlessness relief.