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BETTER-B TRIAL Results
We are delighted that the BETTER-B trial results are now published by the Lancet Respiratory Medicine.
Key finding: the antidepressant Mirtazapine does not alleviate severe breathlessness. Our findings raise questions about using medicines in a manner different from its licence.
To find out more about the trial results, please go to the BETTER-B trial results page in the project menu.
The following briefs contain information on the recommendations from this research:
Patient and carer brief (including translated versions on the European Lung Foundation website)
Policy brief (including translated versions on the European Lung Foundation website)
Further resources on managing breathlessness are available at: Managing breathlessness in advanced illness
National ARC Webinar 2 - Palliative and end of life care, 2 December 2024
This was the second in a series from the NIHR ARC Palliative and End of Life Care National Leadership network, which is jointly led by the NIHR Applied Research Collaborations (ARCs) South London and East of England.
Please find attached the slides from the three presenters:
Mirtazapine to alleviate severe breathlessness in patients with COPD or ILD (findings from Better-B), Professor Irene J Higginson
What works and what doesn’t for non-pharmacological treatments for breathlessness, Professor Matthew Maddocks
What unpaid/family carers need to learn about supporting someone with breathlessness – and a web-based resource to support them, Professor Morag Farquhar
If you were unable to attend or would like to watch the webinar again, you can watch HERE
INSIGHTS FROM THE BETTER-B STUDY: INTERVIEW WITH PROFESSOR HIGGINSON
Interview between Professor Irene Higginson and Touch Respiratory sharing the the rationale behind the Better-B research, discussing the findings, and exploring the implications for clinical practice. Please see here for interview: Interview
PRACTICE REVIEW PUBLISHED
We are very pleased to announce the publication of a Practice review 'Pharmacological management of severe chronic breathlessness in adults with advanced life-limiting diseases'. The review provides practice recommendations on the safe use of pharmacological therapies for severe chronic breathlessness.
THE BETTER-B FINAL CONFERENCES
To find out more about the BETTER-B final conferences that took place on the 4th and 11th of December 2023 and how you can access the recordings and slides from them, please click here.
Breathlessness is the feeling of being out of breath as your lungs work harder to draw in more oxygen. Persistent breathlessness is when this persists long-term, despite treatment of the underlying condition. It is a frightening symptom that leads to increased distress for patients, families and carers.
Research has shown it is often neglected or under-treated. Our international partners have worked to improve its visibility by growing the knowledge base for treatments which work to improve breathlessness self-management and quality of life, and those that don’t.
Because of its link between mind and body, persistent breathlessness is best targeted with a range of treatments to suit the individual. These can focus on non-drug treatments like breathlessness toolkits, however sometimes optimising treatment of the underlying disease plus non-drug treatments are not enough, and so drug treatments sometimes become necessary.
International breathlessness experts from respiratory, palliative care and rehabilitative specialisms are joining in 2019 for a European Commission funded trial to test whether an antidepressant can be repurposed to help in managing breathlessness where non-drug treatments cannot be effectively used.
Recruitment
The BETTER-B main trial recruited a total of 225 patients and 75 caregivers across 16 sites in the UK, Europe, Australia and New Zealand
A PPI member with the Cicely Saunders Institute has provided the following poem about the BETTER-B programme:
The Better B study, a favourite of mine
Offers ample chances for PPI reps to shine
Its aim to help breathlessness, no easy feat
For respiratory conditions can be challenging to treat
Recruitment of patients, a crucial component
We came up with suggestions, novel and diverse
But too many in number to add to this verse
We learnt more about repurposing of medication
Which can sometimes cause a news sensation
As we wait for data to arrive for analysing
You never know if results turn out to be surprising
We had the chance to ask some of our participants who had finished the BETTER-B trial for their opinions, and have been provided us with the following quotes:
“It was personally rewarding for me because I felt as though I was contributing”
“Participation has been very helpful – a very positive outcome. Pleased to work with the research fellow. Could have done without so many questions but strongly urge anybody who is invited to take part to do so. Every little gain is an improvement so go for it!”
“I was well monitored by the team by addressing my concerns and problems. I thank (consultant’s name) for giving me an opportunity to take part in this trial. I am sorry I do not know if it helped me or not. I was hoping to gain a little weigh which I feel I did but very little. Thank you for all your attention and help. I keep positive about this illness.”