Spotlight Series 03

The MABEL Study

MAIN TRIAL RESULTS

143 participants were recruited and randomised of which 140 were included in the data analysis.  We found:

At 28 days: results for the morphine group compared with the placebo group.

  • There was no clear difference in improving breathlessness between those receiving morphine compared to the placebo group
  • There was significant benefit seen in the level of physical activity with participants in the morphine group, on average, completing 10 minutes more moderate-vigorous physical activity per day than those in the placebo group.

At 56 days:

  • There was a significant improvement in the worst cough experienced by participants in the morphine group than in the placebo group.

Overall, morphine was well tolerated:

  • Constipation, nausea and vomiting were more common in participants taking morphine, but these side effects were usually well managed within the first week.
  • Participants in the morphine group did not have more confusion, memory problems or sleepiness than those in the placebo group
  • About 1 in 10 participants were admitted to hospital at some point during the study. However, except for 3 admissions they were not determined to be a result of taking morphine.

The full results paper is published in The Lancet Respiratory Medicine here: https://doi.org/10.1016/S2213-2600(25)00205-X 

ECONOMIC EVALUATION RESULTS

We found:

  • There were more inpatient admissions but fewer outpatient services used by the morphine group compared to the placebo group
  • Oral morphine for chronic breathlessness is likely to be a cost-effective intervention provided side effects are well managed
  • The effect on outcome is small and cautious interpretation of the results is needed, but signal benefits can be seen.

The full results health economics paper is published in The BMJ open here: https://doi.org/10.1136/bmjopen-2025-102124

PROCESS THEORY-INFORMED EVALUATION (Healthcare Professional surveys and training) RESULTS

The sub study team undertook a Mixed-Methods Normalisation Process Theory (a framework for organising data collection and analysis) of Healthcare Professional (HCP) perspectives on prescribing morphine for patients with chronic breathlessness. HCP completed a Learning Needs Assessment (LNA) survey and a Modified Normalisation Measurement instrument (NoMAD) survey at two time-points (pre training and 4 months after training) to identify barriers and facilitators in prescribing morphine.

59 HCP were recruited from 12 sites. These included 28 doctors; 22 non-prescriber nurses; 6 prescriber nurses; 3 other HCP. Of these 90% were hospital-based and 74% were female. Years of clinical experience ranged from 1 to >15 years.

We found:

  • HCP recognised a need for additional learning about the safe prescription and management of morphine for chronic breathlessness in clinical practice.
  • The potential value of morphine was recognised, but there was a lack of training and resources which are barriers to implementation.

A preprint* of the Process theory-informed evaluation is published on medrxiv here: https://www.medrxiv.org/content/10.1101/2025.06.12.25329502v1

INFOGRAPHIC STUDY WITHIN A TRIAL (SWAT) RESULTS

The SWAT investigated whether an Infographic summary of the trial provided alongside the standard Participant Information Sheet (PIS) would boost/support recruitment to the MABEL study.

We found:

  • The consent rate was 16% higher for those receiving the PIS and Infographic (35.1%) compared to those receiving the PIS alone (18.5%).
  • Although results were not statistically significant, the SWAT has demonstrated a positive trend of improved recruitment rates when using the PIS and the Infographic compared to providing the PIS on its own.

The poster* presented at the International Clinical Trials Methodology Conference can be found here:

ICTMC MABEL SWAT poster (FINAL)

*not peer reviewed

November 2025

HHTU News Roundup

Christmas closure

The DAMPen-D 2 study is greenlighted

HHTU Director at SSA Conference

Half year round up










October 2025

HHTU News Roundup








September 2025

HHTU News Roundup









August 2025

HHTU News Roundup

NEWDAY ABC pilot study paper published


6 participants recruited
3 sites opened


6 participants recruited
2 sites opened


3 participants recruited
2 new sites opened


3 participants recruited


Recruitment extended until November


2 participants recruited
2 new sites opened


6 participants enrolled in STARLIT 3
1 participant completed


July 2025

HHTU News Roundup

DOORStep survey collection ended


10 participants recruited

2 new sites opened


17 participants recruited


2 participants recruited


7 participants recruited


4 participants recruited


1 participant recruited


29 participants recruited


STARLIT 3 recruited 3 participants


June 2025

HHTU News Roundup


7 participants recruited
1 new site opened


4 participants recruited


7 participants recruited
3 new sites opened


3 participants recruited


1 participant recruited
1 new site opened


STARLIT 3 has recruited 3 participants


May 2025

HHTU News Roundup






2 participants recruited
1 new site opened


April 2025

HHTU News Roundup


3 new participants consented


3 sites greenlighted

A further 4 sites trained in the study intervention


2 site SIVS held


Received REC approval

Recieved CAG approval pending minor alternations


5 participants in April

1 new site opened

12 month extension agreed


Approvals have now been recevied in Italy


March 2025

HHTU News Roundup

Trial manager presents to UKCRC Trial Manager Operations Group


1 site SIV and 1 Pharmacy SIV were held.


2 SIVs held.

4 site intervention training sessions completed.


5 GP practices randomised. Only 1 more to go.


Both sites in STARLIT 3 are open to recruitment.


21 participants recruited.

Scarborough site has opened for recruitment.