Impact of home spirometry on medication adherence among adolescents with cystic fibrosis

Shakkottai, Aarti; Kaciroti, Niko; Kasmikha, Lauren; Nasr, Samya Z.

doi:10.1002/ppul.23950

Cited by 31 publications

(33 citation statements)

References 39 publications

(106 reference statements)

Supporting

Mentioning

Contrasting

Order By: Relevance

“…There was a small associated overall increase in medication adherence; MPR was 60% in the year prior to study enrolment, and 65% during the 12-month study period (p=0.038). These authors found no change in the number of exacerbations or FEV 1 decline between groups across the study period 33…”

Section: Digital Technology For Monitoring and Promoting Adherence Anmentioning

confidence: 89%

“…Adherence monitoring enables treatment guidance and allows clinicians to differentiate if changes in a patient’s condition are related to disease progression, attributable to poor adherence or a combination of the two. The impact of home monitoring on treatment adherence in adolescents and young adults has been explored in a before and after study using once weekly home monitoring and adherence monitoring using medication prescription refill data to calculate the medication possession ratio (MPR) 33. In comparison to Lechtzin’s eICE study, adherence to weekly spirometry monitoring was 59% which may reflect the impact of parental supervision in this population group.…”

Section: Digital Technology For Monitoring and Promoting Adherence Anmentioning

confidence: 99%

“…However, self-reporting of adherence is notoriously inaccurate and so alternative ways for adherence monitoring are being pursued. Prescription refill data and MPR are a valid and inexpensive way of monitoring adherence; however, this is still prone to inaccuracies, as it is based on the assumption that all of the medications refilled are always taken 33. Hence, digital technologies are being developed to more accurately record treatment adherence 34…”

Section: Digital Technology For Monitoring and Promoting Adherence Anmentioning

confidence: 99%

See 2 more Smart Citations

Using digital technology for home monitoring, adherence and self-management in cystic fibrosis: a state-of-the-art review

Calthorpe

Smith

Gathercole

et al. 2019

Thorax

View full text Add to dashboard Cite

Digital healthcare is a rapidly growing healthcare sector. Its importance has been recognised at both national and international level, with the WHO recently publishing its first global strategy for digital health. The use of digital technology within cystic fibrosis (CF) has also increased. CF is a chronic, life-limiting condition, in which the treatment burden is high and treatment regimens are not static. Digital technologies present an opportunity to support the lives of people with CF. We included 59 articles and protocols in this state-of-the-art review, relating to 48 studies from 1999 until 2019. This provides a comprehensive overview of the expansion and evolution of the use of digital technology. Technology has been used with the aim of increasing accessibility to healthcare, earlier detection of pulmonary exacerbations and objective electronic adherence monitoring. It may also be used to promote adherence and self-management through education, treatment management Apps and social media.

show abstract

Section: Digital Technology For Monitoring and Promoting Adherence Anmentioning

confidence: 89%

Section: Digital Technology For Monitoring and Promoting Adherence Anmentioning

confidence: 99%

Section: Digital Technology For Monitoring and Promoting Adherence Anmentioning

confidence: 99%

See 1 more Smart Citation

Using digital technology for home monitoring, adherence and self-management in cystic fibrosis: a state-of-the-art review

Calthorpe

Smith

Gathercole

et al. 2019

Thorax

View full text Add to dashboard Cite

show abstract

“…The feasibility of video conferencing alongside remote data collection via 'nonconnected' devices has also been explored [65], as have home-based lung function tests supported by regular telephone engagement with the clinical team [59]. These approaches have been shown to support improved adherence to treatment amongst patients [58].…”

Section: Cf Clinical Care Structure and Technologymentioning

confidence: 99%

Exploring the Potential for Technology to Improve Cystic Fibrosis Care Provision

Rodger

O’Hara

2019

Proc. ACM Hum.-Comput. Interact.

View full text Add to dashboard Cite

Health care systems increasingly promote self-management of chronic conditions outside of traditional clinical environments, often through technologies which help to support patient self-care and engagement with medical professionals. We investigate specialist care provision in cystic fibrosis (CF), a life-shortening genetic condition, to understand the experiences of those living with it and of professionals who provide such care. Our work highlights how the motivations for the use of technology in this context are often intrinsically linked to the nature of CF itself and the constraints that the condition imposes on care provision. These include the high burden associated with self-management and clinic attendance; the ever-present risk of infection and a subsequent decline in health; and patients who are often very well-informed and actively engaged in their care. In exploring enablers and barriers to technology in this context, we highlight the importance of considering its integration into the chronic care cycles, practices, and structures of CF care.

show abstract

“…[4][5][6] Our center has been involved in QI work for over 15 years. [7][8][9][10] QI work at our center has been partially supported by the Cystic Fibrosis Foundation (CFF) which has provided QI mentoring, teaching, and support.…”

Section: Introductionmentioning

confidence: 99%

Quality improvement initiative to improve pulmonary function in pediatric cystic fibrosis patients

Filbrun

Enochs

Caverly

et al. 2020

Pediatric Pulmonology

Self Cite

View full text Add to dashboard Cite

Background: Our Cystic Fibrosis (CF) Center initiated a Quality Improvement (QI) project in November 2017 with the goal of improving our patients' forced expiratory volume in 1 second (FEV1) percent predicted (pp) and continued for 1 year. Our specific aim was to increase the relative mean FEV1 pp by 5% in 12 months for CF patients 6 to 21 years old with FEV1 ≤ 80 pp. Methods: We identified patients with FEV1 ≤ 80 pp, developed cause and effect diagrams (fishbones) to identify contributing factors to FEV1 ≤ 80 pp, and created flowcharts to address barriers. The barriers to adherence that may result in FEV1 ≤ 80 pp were studied using a fishbone. A standardized approach across providers was implemented to individualize care for each patient. Each discipline developed a flowchart to address barriers to improving FEV1. Results: Forty patients were identified (43% male). Their mean age was 16.8 years (range 8.2-21.5 years). Mean FEV1 pp at baseline was 58.6 (range 30-80). The fishbone identified needs for continuing education for patients/families, and providing a treatment plan at each clinic visit. After 6 months of implementation, patients had an improvement in mean FEV1 pp by 6.4% (CI, 0.4%-12.9%). At 12 months, mean FEV1 pp had improved by 14% (CI, 6.5%-21.4%), which exceeded our goal of 5%. Conclusion: Through this ongoing project, team members, patients, and families partnered to improve lung function in pediatric CF patients. Flowcharts facilitated a standardized approach across providers to develop individualized treatment plans for patients, which resulted in improved lung function.

show abstract

Impact of home spirometry on medication adherence among adolescents with cystic fibrosis

Abstract: Frequent home PFT monitoring is feasible in CF adolescents and could successfully improve medication adherence without significantly impacting treatment burden.

Cited by 31 publications

References 39 publications

Using digital technology for home monitoring, adherence and self-management in cystic fibrosis: a state-of-the-art review

Using digital technology for home monitoring, adherence and self-management in cystic fibrosis: a state-of-the-art review

Exploring the Potential for Technology to Improve Cystic Fibrosis Care Provision

Quality improvement initiative to improve pulmonary function in pediatric cystic fibrosis patients

Contact Info

Product

Resources

About