{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,15]],"date-time":"2026-10-15T03:17:07Z","timestamp":1792034227999,"version":"4.4.0"},"reference-count":29,"publisher":"Wiley","issue":"3","license":[{"start":{"date-parts":[[2024,12,3]],"date-time":"2024-12-03T00:00:00Z","timestamp":1733184000000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by-nc-nd\/4.0\/"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Respirology"],"published-print":{"date-parts":[[2025,3]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:sec><jats:title>Background and Objective<\/jats:title><jats:p>Pulmonary fibrosis, a manifestation of interstitial lung disease, is frequently associated with anxiety. The objective of this study, COMPANION, was to assess the anxiolytic efficacy of Almee, a digital cognitive behavioural therapy for patients with pulmonary fibrosis, compared to treatment as usual.<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>COMPANION was a randomized, controlled, open\u2010label and partly reader\u2010blinded, decentralized, clinical trial conducted in the United States. Eligible patients had radiology\u2010confirmed pulmonary fibrosis and a Generalized Anxiety Disorder 7\u2010item (GAD\u20107) score of \u22655 (possible range 0\u201321). Participants were randomized 1:1 to Almee or no intervention for 9\u2009weeks, with block stratification by anxiety severity. The primary endpoint was change in GAD\u20107 score from baseline to week 9. Between 20 December 2022 and 14 August 2023, 108 participants were randomized, 54 to Almee and 54 to treatment as usual.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>In each arm, 46 participants completed the study; 108 cases were analysed as intention\u2010to\u2010treat. By week 9, average GAD\u20107 score had improved by 1.8 points (<jats:italic>SEM<\/jats:italic>\u2009=\u20092.1) in the Almee group (<jats:italic>n<\/jats:italic>\u2009=\u200954) and deteriorated by 0.9 points (<jats:italic>SEM<\/jats:italic>\u2009=\u20092.2) in the control group (<jats:italic>n<\/jats:italic>\u2009=\u200954), a 2.7\u2010point difference (95% confidence interval: 1.2\u20134.2, <jats:italic>p<\/jats:italic>\u2009=\u20090.0006).<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusion<\/jats:title><jats:p>Treatment with Almee was well\u2010tolerated and showed clinically meaningful improvement in pulmonary fibrosis\u2010related anxiety. Almee shows promise as a personalized intervention for management of the psychological burden related to living with pulmonary fibrosis.<\/jats:p><jats:p>\n<jats:boxed-text content-type=\"graphic\" position=\"anchor\"><jats:graphic xmlns:xlink=\"http:\/\/www.w3.org\/1999\/xlink\" mimetype=\"image\/png\" position=\"anchor\" specific-use=\"enlarged-web-image\" xlink:href=\"graphic\/resp14859-gra-0001-m.png\"><jats:alt-text>image<\/jats:alt-text><\/jats:graphic><\/jats:boxed-text>\n<\/jats:p><\/jats:sec>","DOI":"10.1111\/resp.14859","type":"journal-article","created":{"date-parts":[[2024,12,4]],"date-time":"2024-12-04T03:11:57Z","timestamp":1733281917000},"page":"253-261","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":10,"title":["A digital therapy targeting anxiety in pulmonary fibrosis: A decentralized randomized controlled trial"],"prefix":"10.1111","volume":"30","author":[{"given":"Joshua 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