Digital therapy improves life quality of patients with pulmonary fibrosis

A novel digital psychological therapy, named Almee, demonstrates efficacy in improving health-related quality of life (HRQOL) in patients with pulmonary fibrosis, irrespective of antifibrotic treatment use, reports a study presented at ATS 2025.

“Pulmonary fibrosis is associated with significant morbidity and mortality and causes substantial impairment of HRQOL,” said lead author Dr Joshua Solomon, Center for Interstitial Lung Disease (ILD), National Jewish Health, Denver, Colorado, US.

“Current pharmacological treatments reduce lung function decline but have not demonstrated improvement in HRQOL, and persistence is due to their side effect profile,” Solomon added.

“Almee has demonstrated the ability to improve psychological health in patients with ILD, and combining Almee with antifibrotic treatment may potentially serve to increase adherence to treatment,” he said.

A total of 108 eligible participants were enrolled in this trial. Of the patients, 54 (mean age 66.2 years, 70.4 percent female, 90.7 percent White) were randomized to Almee and 54 to control (mean age 68.9 years, 61.1 percent female, 92.6 percent White). Sixty percent of the participants had idiopathic pulmonary fibrosis (IPF). [Am J Respir Crit Care Med 2025;211:A1005]

Nearly half of the participants (42 percent) used antidepressants, while 34 percent and 21 percent used nintedanib and pirfenidone, respectively.

Mental health benefits

Almee met the primary endpoint of anxiety reduction, as assessed with General Anxiety Disorder-7 (GAD-7). Compared with control, the digital therapy improved HRQOL, as measured by difference in mean change in KBILD total scores at week 9 by 4.4 points (95 percent confidence interval [CI], 1.6‒7.1; p=0.0019) and KBILD psychological scores by 6.5 points (95 percent CI, 2.5‒10.6; p=0.0015).

Patients on antifibrotic treatment improved their total scores by 3.7 points (95 percent CI, 0.4‒7.0; p=0.030), while those not on antifibrotic treatment improved by 4.9 points (95 percent CI, 0.3‒9.5; p=0.036). Psychological scores improved by 5.9 points (95 percent CI, 1.0‒10.8; p=0.019) and 7.0 points (95 percent CI, 0.3‒13.6; p=0.041), respectively. Similar improvements were noted in IPF and other ILDs.

“Treatment with Almee, the first pulmonary fibrosis-specific digital psychotherapy, significantly improved HRQOL in patients with pulmonary fibrosis, regardless of antifibrotic treatment use or ILD diagnosis,” said Solomon, noting that digital psychological therapy could be an effective treatment modality in improving life quality.

Almee, a digital therapy in development, is easily downloadable to a smartphone or tablet and is specifically designed for use in pulmonary fibrosis. This was tested in a decentralized, open-label, randomized controlled study conducted in the US.

Solomon and his team enrolled patients with pulmonary fibrosis and mild to severe anxiety, assessed using GAD-7, and remotely performed psychometric assessments every 3 weeks. They then measured the effects of Almee on HRQOL using the KBILD total and psychological scores.

“Almee provides a sequence of treatment modules based on cognitive behavioural therapy (CBT), interspersed with educational pulmonary fibrosis modules,” Solomon said.