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Bronchial Thermoplasty: A Novel Therapeutic Approach to Severe Asthma
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Physiotherapy breathing retraining for asthma: a randomised controlled trial.

Anne Bruton1, Amanda Lee2, Lucy Yardley3

  • 1Faculty of Health Sciences, University of Southampton, Southampton, UK; NIHR Southampton Biomedical Research Centre, Southampton, UK.

The Lancet. Respiratory Medicine
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A digital self-guided breathing retraining program improved asthma quality of life for patients. This intervention was as effective as face-to-face sessions and superior to usual care, offering a convenient and cost-effective option.

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Area of Science:

  • Respiratory Medicine
  • Digital Health Interventions
  • Quality of Life Research

Background:

  • Asthma significantly impacts patient quality of life despite pharmacotherapy.
  • Non-pharmacological approaches like breathing retraining are of interest but face access barriers.
  • Limited physiotherapist availability and poor integration hinder standard care for breathing retraining.

Purpose of the Study:

  • To assess the effectiveness of a digital, self-guided breathing retraining intervention for asthma patients.
  • To compare the digital intervention against face-to-face sessions and usual care.
  • To evaluate patient-reported outcomes, physiological measures, acceptability, and costs.

Main Methods:

  • A randomized controlled trial involving 655 adult asthma patients across 34 UK general practices.
  • Participants were assigned to a digital self-guided program (DVDB), face-to-face sessions, or usual care (2:1:2 ratio) for 12 months.
  • The primary outcome was the Asthma Quality of Life Questionnaire (AQLQ) score at 12 months; secondary outcomes included asthma control measures and costs.

Main Results:

  • The digital program (DVDB) significantly improved AQLQ scores compared to usual care (adjusted mean difference 0.28).
  • The face-to-face intervention also showed significant improvement over usual care (adjusted mean difference 0.24).
  • No significant differences in AQLQ scores were found between the digital and face-to-face groups; lung function measures (FEV1, FeNO) showed no significant group differences.

Conclusions:

  • Digital self-guided breathing retraining is an effective intervention for improving asthma-related quality of life.
  • This approach offers comparable effectiveness to traditional face-to-face sessions and is superior to usual care.
  • Digital breathing retraining presents a convenient, potentially cost-effective method to enhance asthma management and patient well-being.