• Margaret Joyce, Maryellen McSweeney, Virginiay L Carrieri-Kohlman, and Josephine Hawkins.
• Cancer Institute of New Jersey, New Brunswick, NJ, USA. joycepe@umdnj.edu
• Oncol Nurs Forum. 2004 May 1;31(3):551-61.

Purpose/ObjectivesTo analyze the evidence about the use of nebulized opioids to treat dyspnea using the Priority Symptom Management (PRISM) level-of-evidence framework and to make a practice recommendation.Data SourcesComputerized database and manual search for articles and abstracts that included experimental trials, chart reviews, and case studies.Data Synthesis20 articles with evaluable evidence were identified. Analysis was complex because of heterogeneous variables and outcome measures. A major limitation is small sample sizes. The majority of PRISM level I and II studies indicated unfavorable evidence.ConclusionsScientific data supporting the use of nebulized opioids to treat dyspnea in patients with chronic pulmonary disease, including malignancy, are lacking.Implications For NursingInsufficient data identify a need for further research with random crossover designs involving larger samples that are stratified according to prior opioid use. Consistency of study variables should be emphasized.

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