Trial reportBMC medicine2014
Is a specialist breathlessness service more effective and cost-effective for patients with advanced cancer and their carers than standard care? Findings of a mixed-method randomised controlled trial.
Trial report in BMC medicine, 2014. The graph could read no effect estimate from its abstract, so it casts no vote on the map. It is linked to 2 registered trials, which are not on this map. Cited by 70 papers, 11 of them syntheses that pooled it.
What it found
Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.
The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.
The trial behind it
Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.
Phase III Randomized Controlled Trial of a Breathlessness Intervention Service for Intractable Breathlessness.
A Feasibility, Randomised Controlled Trial of Tele-rehabilitation Following COVID-19
Who cites it
70 citing papers in PubMed, 11 syntheses or guidelines pooled it.
- Economic evaluations in the palliative and end-of-life care settings: A systematic review of existing evidence, methods and quality.Palliative medicine · 2026Pooled it
- BreathCarer: Informal carers of patients with chronic breathlessness: a mixed-methods systematic review of burden, needs, coping, and support interventions.BMC palliative care · 2025Pooled it
- Systematic review of the literature on the occurrence and characteristics of dyspnea in oncology patients.Critical reviews in oncology/hematology · 2023Pooled it
- A systematic review of impact of person-centred interventions for serious physical illness in terms of outcomes and costs.BMJ open · 2022Pooled it
- The effectiveness and cost-effectiveness of hospital-based specialist palliative care for adults with advanced illness and their caregivers.The Cochrane database of systematic reviews · 2020Pooled it
- Comparing Specialty and Primary Palliative Care Interventions: Analysis of a Systematic Review.Journal of palliative medicine · 2020Pooled it
- Are the MORECare guidelines on reporting of attrition in palliative care research populations appropriate? A systematic review and meta-analysis of randomised controlled trials.BMC palliative care · 2020Pooled it
- Holistic services for people with advanced disease and chronic breathlessness: a systematic review and meta-analysis.Thorax · 2019Pooled it
- Systemic corticosteroids for the management of cancer-related breathlessness (dyspnoea) in adults.The Cochrane database of systematic reviews · 2019Pooled it
- Implementing Evidence-Based Palliative Care Programs and Policy for Cancer Patients: Epidemiologic and Policy Implications of the 2016 American Society of Clinical Oncology Clinical Practice Guideline Update.Epidemiologic reviews · 2017Pooled it
- Pooled it
- Characterization of multidimensional dyspnea in advanced lung cancer with moderate to severe dyspnea-related functional impairment: a latent profile analysis.Supportive care in cancer : official journal of the Multinational Association of Supportive Care in Cancer · 2025Trial
- Complex breathlessness intervention in idiopathic pulmonary fibrosis (BREEZE-IPF): a feasibility, wait-list design randomised controlled trial.BMJ open respiratory research · 2025Trial
- What are the views of those participating in a trial investigating acute post-traumatic benign paroxysmal positional vertigo? A qualitative study.Brain injury · 2025Trial
- A mixed-methods pilot study of handheld fan for breathlessness in interstitial lung disease.Scientific reports · 2021Trial
- Oral modified release morphine for breathlessness in chronic heart failure: a randomized placebo-controlled trial.ESC heart failure · 2019Trial
- Contributions of a hand-held fan to self-management of chronic breathlessness.The European respiratory journal · 2017Trial
- How effective are volunteers at supporting people in their last year of life? A pragmatic randomised wait-list trial in palliative care (ELSA).BMC medicine · 2016Trial
- Trial
- Trial
10 more citing papers are in PubMed but not listed here.
Corrections and comments
PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.
Authors and funding
8 authors.
Funding
Abstract
backgroundBreathlessness is common in advanced cancer. The Breathlessness Intervention Service (BIS) is a multi-disciplinary complex intervention theoretically underpinned by a palliative care approach, utilising evidence-based non-pharmacological and pharmacological interventions to support patients with advanced disease. We sought to establish whether BIS was more effective, and cost-effective, for patients with advanced cancer and their carers than standard care.
methodsA single-centre Phase III fast-track single-blind mixed-method randomised controlled trial (RCT) of BIS versus standard care was conducted. Participants were randomised to one of two groups (randomly permuted blocks). A total of 67 patients referred to BIS were randomised (intervention arm n = 35; control arm n = 32 received BIS after a two-week wait); 54 completed to the key outcome measurement. The primary outcome measure was a 0 to 10 numerical rating scale for patient distress due to breathlessness at two-weeks. Secondary outcomes were evaluated using the Chronic Respiratory Questionnaire, Hospital Anxiety and Depression Scale, Client Services Receipt Inventory, EQ-5D and topic-guided interviews.
resultsBIS reduced patient distress due to breathlessness (primary outcome: -1.29; 95% CI -2.57 to -0.005; P = 0.049) significantly more than the control group; 94% of respondents reported a positive impact (51/53). BIS reduced fear and worry, and increased confidence in managing breathlessness. Patients and carers consistently identified specific and repeatable aspects of the BIS model and interventions that helped. How interventions were delivered was important. BIS legitimised breathlessness and increased knowledge whilst making patients and carers feel 'not alone'. BIS had a 66% likelihood of better outcomes in terms of reduced distress due to breathlessness at lower health/social care costs than standard care (81% with informal care costs included).
conclusionsBIS appears to be more effective and cost-effective in advanced cancer than standard care.
trial registrationRCT registration at ClinicalTrials.gov NCT00678405 (May 2008) and Current Controlled Trials ISRCTN04119516 (December 2008).
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Registered trials
Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.