Feasibility trial of a digital self-management intervention ‘My Breathing Matters’ to improve asthma-related quality of life for UK primary care patients with asthma

Abstract

ObjectiveTo assess the feasibility of a randomised controlled trial (RCT) and acceptability of an asthma self-management digital intervention to improve asthma-specific quality of life in comparison with usual care.Design and settingA two-arm feasibility RCT conducted across seven general practices in Wessex, UK.ParticipantsPrimary care patients with asthma aged 18 years and over, with impaired asthma-specific quality of life and access to the internet.Interventions‘My Breathing Matters’ (MBM) is a digital asthma self-management intervention designed using theory, evidence and person-based approaches to provide tailored support for both pharmacological and non-pharmacological management of asthma symptoms.OutcomesThe primary outcome was the feasibility of the trial design, including recruitment, adherence and retention at follow-up (3 and 12 months). Secondary outcomes were the feasibility and effect sizes of specific trial measures including asthma-specific quality of life and asthma control.ResultsPrimary outcomes: 88 patients were recruited (target 80). At 3-month follow-up, two patients withdrew and six did not complete outcome measures. At 12 months, two withdrew and four did not complete outcome measures. 36/44 patients in the intervention group engaged with MBM (median of 4 logins, range 0–25, IQR 8). Consistent trends were observed to improvements in asthma-related patient-reported outcome measures.ConclusionsThis study demonstrated the feasibility and acceptability of a definitive RCT that is required to determine the clinical and cost-effectiveness of a digital asthma self-management intervention.Trial registration number ISRCTN15698435.

Mixed methods process evaluation of my breathing matters, a digital intervention to support self-management of asthma

“…In this way, even when users considered the intervention not specifically necessary for asthma control, My Breathing Matters still provided self-management support. Users reported several benefits of the intervention, and our feasibility study observed trends with improvement across a range of asthma outcomes 24 . This demonstrates that interventions developed using theory-based, evidence-based, and person-based approaches that target likely barriers to behaviour change can lead to effective user engagement and positive outcomes among individuals with different health beliefs, such as those in heterogeneous chronic disease populations.…”

“…Outcome measures were assessed at baseline, 3 months and 12 months. Further details on the trial methods and feasibility outcomes are available elsewhere 24 . Quantitative usage data were collected to describe patterns of intervention usage over the 12-month study period.…”

“…Participants also needed to have an impaired asthma-related health status at baseline, defined as a Mini Asthma Quality of Life Questionnaire 45 score of less than 5.5. Full trial inclusion and exclusion criteria are described elsewhere 24 .…”

“…It was developed using theory-based, evidence-based, and person-based approaches to intervention development to maximise its effectiveness, feasibility and acceptability 15 , 22 , 23 . Trial feasibility outcomes (such as recruitment, retention, and randomisation) in our randomised controlled feasibility trial (RCT) with 88 adults with asthma showed that a definitive RCT is feasible 24 . In addition, we observed consistent trends with improvements in asthma-related patient-reported outcome measures, including quality of life and asthma control.…”

A feasibility trial of a digital mindfulness-based intervention to improve asthma-related quality of life for primary care patients with asthma

“…Digital mindfulness interventions could potentially offer alternatives to traditional programmes, allowing accessibility to content that has been created and validated by experts, across a heterogenous population at low-cost. Digital self-management support interventions have been successfully trialled in asthma, with patient acceptability (Ainsworth et al, 2019a;Morrison et al, 2016). Web-based MBIs have shown some benefit in alleviating symptom burden across non-respiratory chronic conditions (Toivonen et al, 2017), but to date a digital mindfulness intervention has not been evaluated for adults with asthma.…”