Study Finds Breathing Retraining Associated With Quality of Life Improvement for Patients With Asthma

Despite effective pharmacology, many patients with asthma have impaired quality of life, but a new breathing retraining intervention can be used as a nonpharmacological intervention to treat asthma.

Up to 18% of the world’s population is affected by asthma, which impairs quality of life for most patients despite effective pharmacology. Researchers in the United Kingdom sought to understand the effectiveness of a self-guided breathing retraining intervention, which can be used as a nonpharmacological intervention to treat asthma. The study was published in The Lancet Respiratory Medicine.

The authors recruited 655 patients from 34 general practices in the United Kingdom and randomized them in a 2:1:2 ratio to 1 of 3 arms: patients who received a DVD of the self-guided intervention plus a printed booklet; patients who received 3 face-to-face breathing retraining sessions; and patients who received standard care. The authors noted that previous trials have found benefits of breathing retraining.

“Our findings suggest that a self-help breathing intervention can be offered conveniently and cost-effectively alongside usual drug treatments to people with asthma whose quality of life is impaired by their disease, despite treatment,” lead author Mike Thomas, PhD, of the University of Southampton in the United Kingdom, said in a statement. “In the UK, over 5 million people have asthma and although drug treatments can improve symptoms, many people live with persistent symptoms that impair their quality of life. With these patients often expressing interest in other medication-free ways to manage their symptoms, we hope that our results will offer an effective addition to usual treatment.”

Participants were followed for 12 months, and their Asthma Quality of Life Questionnaire (AQLQ) results baselines were compared with the new scores at 12 months. Baseline data were similar among the 3 study arms. At the end of 12 months, the mean AQLQ scores were 5.4 (SD 1.14) in the group that received the DVD plus booklet, 5.33 (SD 1.06) in the group receiving face-to-face coaching, and 5.12 (1.17) in the group receiving usual care.

The largest improvements were seen in the emotion subdomain with the DVD and face-to-face groups showing improvements compared with the usual care group. The researchers reported that there were no significant differences in overall or individual domain scores between the DVD and the face-to-face groups.

The 2 interventions also saved money compared to usual care. Mean annual National Health Service medical costs were £296 ($394.17) for the DVD group compared with £335 ($446.11) for the face-to-face group and £356 ($474.07) for the usual care group.

The 3-month questionnaires and the qualitative interviews found that patient experiences of both interventions were favorable. The participants in the interventions perceived the following benefits of the inventions: increased control over breathing, reduced need for medication, feeling more relaxed, and improved quality of life.

The authors noted that, since the use of DVDs has declined considerably since the study began, the intervention is now available online. While this intervention can now be offered to people with asthma whose quality of life is impaired, it should not be the sole intervention, they added.

“There is a need to stress to patients that this intervention is in addition to, not instead of, current medication, and that it does not cure asthma, but rather is a means to improve quality of life,” the authors concluded.

References

Bruton A, Lee A, Yardley L, et al. Physiotherapy breathing retraining for asthma: a randomized controlled trial. Lancet Respir Med. Published online December 13, 2017. http://dx.doi.org/10.1016/.