Respiratory
A Patient-Centered Approach to Airway Clearance
Considerations for effective chronic lung disease management outside of the clinic
By Anat Shani
For patients living with chronic lung conditions such as bronchiectasis and cystic fibrosis, airway clearance therapy is a cornerstone of disease management. Mobilizing and removing mucus from the lungs is vital to prevent recurring exacerbations, slow disease progression and improve quality of life.
Driven by rising bronchiectasis diagnosis rates and extended life expectancies for cystic fibrosis patients, the population requiring lifelong, daily airway clearance is expanding rapidly. At the same time, routinely managing these patients within a clinic is not practical—a challenge intensified by systemic respiratory therapist staffing shortages across the United States healthcare system. These dynamics have accelerated a transition toward patient-driven disease management at home.
Moving care to the home involves more than just delivering a medical device to a patient’s doorstep. When responsibility for daily treatment shifts from the clinic to the home, patients must be empowered to confidently and effectively perform daily therapy without the ongoing training and guidance that a respiratory therapist would provide in the clinic. Therefore, integrating airway clearance into a daily routine requires solutions that are designed from inception for independent home use.
Putting the Patient at the Center of Design
Clinicians prescribing homecare therapies should focus on the individual patient to ensure they receive the best treatment for their unique needs. As with many conditions, respiratory therapy is not one size fits all—age, disease severity, secretion characteristics and comorbidities all need to be considered in the treatment approach for any given patient.
For instance, cystic fibrosis patients often master airway clearance techniques in childhood, whereas bronchiectasis generally presents later in life across a wide spectrum of adults with varying medical histories. Since pediatric, adult and aging populations requiring respiratory care have different daily routines and needs, any device designed for home use must accommodate the lifestyles of the intended users.
User experience is therefore inherently intertwined with the development of any solution intended for independent use. Design considerations such as the physical characteristics of a device, its user interface, how it integrates with other treatment modalities and how engaging it is during use all factor into how a patient experiences the therapy day after day.
Comfort and a frictionless experience can affect adherence directly, as even the most effective therapy will be avoided if patients find it unpleasant to use.
An ideal way to discover the driving factors for optimal user satisfaction is to keep patients involved in the development process from the start, and constantly iterate with additional patient feedback. The goal is a simple-to-operate, intuitive design with the ability to deliver proven clinical efficacy.
Bringing Respiratory Therapies Home
While numerous airway clearance devices are available, many patients still do not achieve optimal outcomes due to improper use, insufficient efficacy, intolerability or lack of access to existing modalities. Furthermore, not all airway clearance techniques translate easily to independent home use.
One example of this challenge is the autogenic drainage airway clearance technique. While recognized as highly effective, it traditionally requires reliance on expert respiratory therapists for training and guidance. The technique works by modulating breathing at varying lung volumes to generate controlled changes in airflow, mobilizing mucus from the smaller peripheral airways toward the central airways where it can be cleared by coughing. Performed correctly, it is highly efficacious. However, it requires an exact technique, and most patients struggle to reach the level of skill that makes it viable for sustained independent use.
Our team worked to bridge this gap by automating complex, therapist-led techniques in a patient-driven solution. The clinician’s support was translated into an app that guides patients through specific breathing patterns, while a vest delivers synchronized chest compressions mimicking an expert therapist externally directing airflow. This technology makes it feasible for patients to perform on their own, at home, every day.
Clinical studies validated this approach, demonstrating that patients were able to clear twice the amount of sputum with the technology compared to traditional therapies, while reporting higher comfort and satisfaction scores.
Comfort & a frictionless experience can affect adherence directly, as even the most effective therapy will be avoided if patients find it unpleasant to use.
Feeling the Benefits Helps Motivate Patients
Ultimately, patients stick with therapies they can feel working. With effective airway clearance, the benefits are apparent even before the therapy session ends through notable mucus expectoration, and the effect carries throughout the day with easier breathing. Thorough lung clearance leads to reduced coughing, improved sleep quality and overall better quality of life.
The experience of noticeably improved health can be an intrinsic motivation for long term adherence, in a way that automated digital reminders or periodic clinician check-ins may not.
For homecare providers and clinicians evaluating airway clearance options, the combination of proven clinical results along with overall user experience must be considered to ensure long-term outcomes. For individuals living with chronic lung conditions, improved respiratory care goes far beyond better clinical metrics; it provides freedom to live life to the fullest, without being sidelined by their chronic condition.
Therapies designed fundamentally around the patient as the independent operator are the ones that can truly empower patients, serving as the foundation of effective chronic disease management.
Anat Shani is the co-founder and CEO of Synchrony Medical. A biomedical engineer with over a decade of experience developing wearable medical devices, Shani holds a BS in bio-medical engineering from Ben-Gurion University and an MBA focused on entrepreneurship and innovation from Reichman University. Visit synchronymed.com.
Adobestock.com Sebastian Kaulitzki
