Abstract
Introduction: Bronchiectasis is a chronic airways disease characterized by frequent exacerbations as a result of bronchial infections. Adherence to treatments is a major challenge in these patients. Digital tools may help increase the adherence to different therapeutic strategies in these patients.
Method: We sought to assess the viability of the implementation of a comprehensive care program, based on digital health, aimed to improving adherence to treatment and patient management in bronchiectasis. We designed a clinical trial with two arms (1:1, intervention and placebo, n=20, 6 months), in which bronchiectasis patients (Specialized Unit, Hospital del Mar, Barcelona) will be followed up to 12 months. Disease severity scores (BSI, FACED, and EFACED), QoL, and physical activity (PA) (EUROQOL-5D and Sant George, IPAQ, respectively) were assessed at baseline and 6 months and will also be assessed at 12 months. Interventions were implemented through the digital ecosystem HappyAir® (validated in COPD) by a respiratory physiotherapist.
Results: All patient participants completed the 12-month study. At baseline, no significant differences were observed regarding lung function, physical activity, symptoms, quality of life, and severity scales. At the 12-month assessment, the total score of the Saint George respiratory questionnaire [-9.67 (11.12) versus +2.34 (8.99), p = 0.023] and the dimensions of physical activity [-9.79 (13.13) versus +2.96 (15.03), p = 0.049] and symptoms [-20.33 (15.57) versus -4.59 (15.99), p = 0.49] improved in the intervention group.
Conclusions: The HappyAir® digital Ecosystem has been beneficial regarding the improvement in the dimensions of physical and clinical activity, as well as in the total score of the Saint George questionnaire. In the absence of evidence from larger, multicenter studies, this ecosystem is promising for implementation in routine virtual care clinical practice by physiotherapy professionals in coordination with hospital healthcare teams.