The effect of regular, low-dose, sustained-release morphine on routine physical activity in people with persistent breathlessness- a hypothesis-generating study.

Chronic breathlessness, which may be better described as persistent breathlessness to optimise applicability to different languages, is a frequent cause of disability in COPD [1]. In many people with advanced COPD, optimising treatment for the underlying causes of breathlessness and employing non-pharmacological approaches does not achieve symptom control [2]. Some people with persistent breathlessness may benefit from regular, low-dose, sustained-release (SR) morphine [3]. Importantly, changes in unidimensional breathlessness measures do not always reflect the patient's perspective of benefit [4]. Optimal ways of measuring meaningful changes in persistent breathlessness are debated [5], but small functional gains are valued by patients [6]. These gains may be reflected in periods of more intense energy expenditure, allowing people to better maintain independence.