A home monitoring program including real-time wireless home spirometry in idiopathic pulmonary fibrosis: a pilot study on experiences and barriers

Moor, Catharina C.; Wapenaar, Monique; Miedema, Jelle; Geelhoed, J.J. Miranda; Chandoesing, Prewesh P.; Wijsenbeek, Marlies

doi:10.1186/s12931-018-0810-3

Cited by 59 publications

(90 citation statements)

References 9 publications

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“…The authors of this study identified a diurnal variation with higher FVC values in the morning compared to the afternoon. In line with our observations, two other studies described FVC variability of 0.04 to 0.39 L over 28 days of home spirometry in patients with IPF [ 12 , 28 ]. Indeed, these analyses were only used to evaluate within-subject reproducibility of measurements and were not analysed for their correlation with disease progression [ 12 , 28 ].…”

Section: Discussionsupporting

confidence: 93%

Variability of forced vital capacity in progressive interstitial lung disease: a prospective observational study

et al. 2020

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Background Fibrotic interstitial lung disease (ILD) is often associated with poor outcomes, but has few predictors of progression. Daily home spirometry has been proposed to provide important information about the clinical course of idiopathic pulmonary disease (IPF). However, experience is limited, and home spirometry is not a routine component of patient care in ILD. Using home spirometry, we aimed to investigate the predictive potential of daily measurements of forced vital capacity (FVC) in fibrotic ILD. Methods In this prospective observational study, patients with fibrotic ILD and clinical progression were provided with home spirometers for daily measurements over 6 months. Hospital based spirometry was performed after three and 6 months. Disease progression, defined as death, lung transplantation, acute exacerbation or FVC decline > 10% relative was assessed in the cohort. Results From May 2017 until August 2018, we included 47 patients (IPF n = 20; non-IPF n = 27). Sufficient daily measurements were performed by 85.1% of the study cohort. Among these 40 patients (IPF n = 17; non-IPF n = 23), who had a mean ± SD age of 60.7 ± 11.3 years and FVC 64.7 ± 21.7% predicted (2.4 ± 0.8 L), 12 patients experienced disease progression (death: n = 2; lung transplantation: n = 3; acute exacerbation: n = 1; FVC decline > 10%: n = 6). Within the first 28 days, a group of patients had high daily variability in FVC, with 60.0% having a variation ≥5%. Patients with disease progression had significantly higher FVC variability than those in the stable group (median variability 8.6% vs. 4.8%; p = 0.002). Cox regression identified FVC variability as independently associated with disease progression when controlling for multiple confounding variables (hazard ratio: 1.203; 95% CI:1.050–1.378; p = 0.0076). Conclusions Daily home spirometry is feasible in IPF and non-IPF ILD and facilitates the identification of FVC variability, which was associated with disease progression.

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Section: Discussionsupporting

confidence: 93%

Variability of forced vital capacity in progressive interstitial lung disease: a prospective observational study

et al. 2020

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“…Co-development of home monitoring systems with patients might lead to higher adherence and patient satisfaction with home monitoring. 8 , 9 The identified statistical analysis challenges could be tackled by predefining the minimum number of measurements that are needed for reliable longitudinal analysis, and unifying the way that missing data and outliers are handled.…”

mentioning

confidence: 99%

Home monitoring for patients with ILD and the COVID-19 pandemic

Nakshbandi

Moor

Wijsenbeek

2020

The Lancet Respiratory Medicine

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2 Lamontagne F, Agoritsas T, Macdonald H, et al. A living WHO guideline on drugs for covid19. BMJ 2020; 370: m3379. 3 Dequin PF, Heming N, Meziani F, et al. Effect of hydrocortisone on 21day mortality or respiratory support among critically ill patients with COVID19: a randomized clinical trial. JAMA 2020; 324: 1298-306. 4 Tomazini BM, Maia IS, Cavalcanti AB, et al. Effect of dexamethasone on days alive and ventilatorfree in patients with moderate or severe acute respiratory distress syndrome and COVID19: the CoDEX randomized clinical trial. JAMA 2020; 324: 1307-16. 5 Angus DC, Derde L, AlBeidh F, et al. Effect of hydrocortisone on mortality and organ support in patients with severe COVID19: the REMAPCAP COVID19 corticosteroid domain randomized clinical trial. JAMA 2020; 324: 1317-29. 6 The WHO Rapid Evidence Appraisal for COVID19 Therapies (REACT) Working Group. Association between administration of systemic corticosteroids and mortality among critically ill patients with COVID19: a metaanalysis.

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“…On the other hand, ILD specialists need to better interact The main symptoms that drive QoL in IPF are cough, dyspnoea and anxiety 28 . Different treatment strategies have been used to relieve chronic cough and progressive dyspnoea associated with pulmonary fibrosis, presenting limited evidence and modest results 29,[40][41][42][43][44][45][46][47] .…”

Section: Palliation Of Symptomsmentioning

confidence: 99%

“…Finally, increasing shortness of breath and immobility in advanced stages represent another challenge for many patients and create problems in accessing healthcare. New home care programs that incorporate eHealth technologies hold vast potential for facilitating real-time data about patient situation and requirements 41,50 . Therefore, the ILD community should work to find better options for symptom palliation from initial stages of the disease and also to set the best healthcare strategy for patient acceptance and participation in care.…”

Section: Palliation Of Symptomsmentioning

confidence: 99%

Comprehensive Care in Pulmonary Fibrosis

Molina-Molina¹,

Wijsenbeek²

2021

BRN

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Pulmonary fibrosis is a respiratory condition that associates progressive loss of quality of life mainly due to respiratory failure with emotional impairment due to the loss of autonomy and the poor prognosis. These clinical conditions and the poor prognosis would require a strategy closer to lung cancer than to other respiratory diseases. However, most centres that manage patients with pulmonary fibrosis have not enough resources to properly provide the multidisciplinary approach that they require. Idiopathic pulmonary fibrosis (IPF) is the most frequent and lethal form of lung fibrosis, for which two anti-fibrotic drugs have demonstrated to slowdown disease progression. Both drugs require a close monitoring to ensure adherence and to prevent or reduce adverse effects. Currently, there is an increased demand of improving the multidisciplinary integral treatment of IPF and other lung fibrotic entities to optimise drug benefits and quality of life during the different stages of the disease, including end of life.

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A home monitoring program including real-time wireless home spirometry in idiopathic pulmonary fibrosis: a pilot study on experiences and barriers

Cited by 59 publications

References 9 publications

Variability of forced vital capacity in progressive interstitial lung disease: a prospective observational study

Variability of forced vital capacity in progressive interstitial lung disease: a prospective observational study

Home monitoring for patients with ILD and the COVID-19 pandemic

Comprehensive Care in Pulmonary Fibrosis

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