Feasibility of a digital ecosystem for patients with non-cystic bronchiectasis: a pilot randomized controlled trial

This research project aims to evaluate the feasibility, usability, and preliminary effectiveness of the HappyAir® Digital Ecosystem —a digitally supported self‑management program— in adult patients diagnosed with non‑cystic bronchiectasis. Bronchiectasis is a chronic and progressive respiratory condition characterized by recurrent infections, impaired airway clearance, and substantial reductions in health‑related quality of life (HRQoL). Traditional management usually requires complex pharmacological regimens combined with physiotherapy and lifestyle interventions, making long‑term adherence a major challenge in this population. The HappyAir® Digital Ecosystem has been designed to support patients in the daily management of their condition through three integrated components: i) a secure communication channel enabling regular contact between patients and a certified respiratory physiotherapist (HappyAir® coach), ii) a web‑based clinical platform for monitoring symptoms, treatment adherence, physiological parameters, and lifestyle behaviours, and iii) a digital educational hub providing tailored resources related to disease understanding, airway‑clearance techniques, inhalation therapy, and physical activity habits. In this pilot randomized controlled trial, participants will be allocated either to a 6‑month intervention using the HappyAir® ecosystem plus remote physiotherapist support, or to a control group receiving usual medical care. The study will assess the feasibility of the intervention through recruitment and retention rates, engagement metrics, and patient satisfaction. In addition, exploratory analyses will examine potential effects on HRQoL (EUROQOL‑5D and St George’s Respiratory Questionnaire), disease severity scores (BSI, FACED, EFACED), pulmonary function (spirometry), and self‑reported physical activity (IPAQ). Expected outcomes of the study include evidence that the digital ecosystem is a feasible and acceptable solution for patients with non‑cystic bronchiectasis, and that it may lead to improvements in self‑management skills, symptom control, mobility, and overall HRQoL. As a pilot trial, the project is intended to inform the design of future, larger‑scale studies evaluating the clinical impact of digitally supported care in this population.