Unfair treatment

[摘要] The recent article1 on patients dying of chronic cardiorespiratory disease demonstrates an important defect in our provision of services. The associated leading article2 stated that symptom patterns for patients with cancer or cardiorespiratory disease are similar, including depression, cachexia, fatigue and generalised pain, in addition to the severe breathlessness that characterises advanced heart and lung disease. In fact, quality of life, psychological morbidity and debility often appear to be worse in patients with non-malignant disease. For instance, in a comparison of patients dying of lung cancer and of COPD, 90% of the patients with COPD and 52% of the patients with cancer had clinically important anxiety or depression.3 Despite this, McKinley found that the inverse care law applied: 45% of patients with cancer and 12% of patients with non-malignant disease received antidepressants.1 Opioids provide effective relief from dyspnoea, with relatively few adverse effects:4 opioids were given to 57% of patients with cancer, but only 13% of patients with cardiorespiratory disease.1

[学科分类] 卫生学