A NEW study suggests that therapist-guided, internet-delivered cognitive behavioural therapy (ICBT) can effectively reduce anxiety and improve asthma-related outcomes, providing clinicians with a scalable, evidence-based adjunct to routine care.
Tackling Asthma Anxiety
Anxiety affects up to a third of adults with asthma and is associated with worse disease control, increased avoidance behaviours, and lower quality of life. This randomised controlled trial enrolled 90 adults experiencing anxiety linked to asthma and compared 8 weeks of therapist-guided ICBT with standard medical care plus educational support.
Internet CBT Leads to Significant Reductions in Catastrophising
The primary outcome, measured using the Catastrophising about Asthma Scale, showed a marked reduction in anxiety for the ICBT group compared with controls (mean difference: –18.53, 95% CI: –25.54 to –11.53, p<0.001). Reduced catastrophising is linked with better adherence, fewer symptom flare-ups, and improved self-management.
Improved Asthma Control and Quality of Life
Secondary outcomes also favoured ICBT. Participants reported enhanced asthma control, decreased avoidance behaviours, and improved quality of life. Notably, these benefits were sustained at 6 months post-treatment, suggesting long-term value. Objective lung function, measured as FEV1 using a digital spirometer, remained unchanged, indicating that improvements were primarily behavioural and psychological rather than physiological.
Internet CBT as a Complement to Routine Care
This study reinforces the role of ICBT as a safe, practical adjunct to standard asthma management. By addressing the psychological burden of asthma, clinicians can support patients in reducing anxiety-driven avoidance and improving daily functioning. Remote delivery also increases accessibility, making therapy feasible for patients who face barriers to attending in-person sessions.
Implications for Clinical Practice
For healthcare professionals, integrating ICBT into asthma care pathways could enhance holistic management, especially for patients with comorbid anxiety. While it does not replace pharmacological treatment, it offers a low-risk, evidence-based method to improve patient outcomes and quality of life.
Reference
Bonnert M et al. Online cognitive behaviour therapy for asthma-related anxiety: a randomised controlled trial. Thorax. 2026; DOI:10.1136/thorax-2025-223886.
