Quality of home spirometry performance amongst adults with cystic fibrosis

Bell, J M; Sivam, Sheila; Dentice, Ruth; Dwyer, Tiffany; Jo, Helen; Lau, Edmund; Muñoz, Phillip A.; Nolan, Samantha A; Taylor, Nicole; Visser, S.; Yozghatlian, V.; Wong, Keith

doi:10.1016/j.jcf.2021.10.012

Cited by 19 publications

(20 citation statements)

References 7 publications

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“…In the present study, we found that Other studies have mixed findings regarding acceptable technique in an unsupervised setting. 9,14,17 Usability in an unsupervised setting is a critical point to address before home monitoring becomes sustainable. 5 As previously described 11,14 participants in our study viewed home spirometry favorably, reporting comfort from tracking their lung function.…”

Section: Discussionmentioning

confidence: 99%

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Real‐world feasibility of short‐term, unsupervised home spirometry in CF

Davis

Ryan

Marchetti

et al. 2022

Pediatric Pulmonology

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Objectives: The objective of this study was to study the performance of two available home spirometers used by people with Cystic Fibrosis (PwCF) over a shortterm period and to assess user experience. Study design: This was a prospective observational study. Participants age 6 years and older were recruited to participate if they could complete acceptable spirometry in the clinic setting. Methods: Participants used either the NuvoAir Air Next or the ZEPHYRx MIR Spirobank Smart spirometer. They underwent a one-time virtual training session, then completed 2 weeks of daily spirometry followed by 2 months of weekly spirometry. Participants responded to surveys and completed a debrief interview to understand user experience. Statistical analyses examined feasibility, reliability, and accuracy of each spirometer in an unsupervised, real-world setting.Results: We report high adherence (80% [95% CI 61%-92%]) to our study protocol in all session attempts, but lower rates of adherence after discarding sessions performed with inadequate technique (47% [95% CI 28%-66%] to 63% [95% CI 44%-80%]). We found high reliability of each device by analyzing day-to-day variability and good concordance to recent in-clinic testing (NuvoAir r = 0.91 [0.82-0.93]; ZEPHYRx r = 0.70 [0.45-0.84]). Patient experience in this cohort was favorable with most reporting ease of use and reassurance knowing lung function was being tracked over time. Conclusions: This real-world study showed good performance of two different available home spirometers used by children and adults with CF. While overall adherence was high, suboptimal technique reduced the total interpretable data, possibly limiting feasibility. Future work should focus on developing sustainable training and coaching programs to support the success of home spirometry in a CF chronic care model.

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Section: Discussionmentioning

confidence: 99%

“…We did not find differences in baseline characteristics among the adherers and nonadherers. Other studies have mixed findings regarding acceptable technique in an unsupervised setting 9,14,17 . Usability in an unsupervised setting is a critical point to address before home monitoring becomes sustainable 5 …”

Section: Discussionmentioning

confidence: 99%

Real‐world feasibility of short‐term, unsupervised home spirometry in CF

Davis

Ryan

Marchetti

et al. 2022

Pediatric Pulmonology

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“…However, the usefulness of these devices requires both good patient compliance and reliable and reproducible results compared to conventional spirometry. Home spirometry telemonitoring devices have already demonstrated a good quality of performed spirometry (13), adherence (14) and a good reliability of home spirometry results compared to lung function results obtained in a dedicated laboratory in a small group of CF patients (14)(15)(16). However, most of the studies involving home spirometry included mainly teenagers (12-18 years old) and/or adults (>18 years old) (13,(16)(17)(18).…”

Section: Introductionmentioning

confidence: 99%

“…Home spirometry telemonitoring devices have already demonstrated a good quality of performed spirometry (13), adherence (14) and a good reliability of home spirometry results compared to lung function results obtained in a dedicated laboratory in a small group of CF patients (14)(15)(16). However, most of the studies involving home spirometry included mainly teenagers (12-18 years old) and/or adults (>18 years old) (13,(16)(17)(18). The differences in adherence, reliability and variability of home spirometry between children, teenagers and adults with CF have never been assessed previously.…”

Section: Introductionmentioning

confidence: 99%

Adherence, reliability, and variability of home spirometry telemonitoring in cystic fibrosis

Beaufils

Enaud²,

Gallode³

et al. 2023

Front. Pediatr.

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IntroductionForced spirometry is the gold standard to assess lung function, but its accessibility may be limited. By contrast, home spirometry telemonitoring allows a multi-weekly lung function follow-up but its real-life adherence, reliability, and variability according to age have been poorly studied in patients with CF (PwCF). We aimed to compare real-life adherence, reliability and variability of home spirometry between children, teenagers and adults with CF.MethodsThis real-life observational study included PwCF followed for six months in whom lung function (i.e, forced expiratory volume maximum in 1 s (FEV1), forced vital capacity (FVC), forced mid-expiratory flow (FEF) and FEV1/FVC ratio) was monitored by both conventional and home spirometry between July 2015 and December 2021. The adherence, reliability and variability of home spirometry was assessed in all PwCF and compared between children (<12years old), teenagers (12–18 years old) and adults.Results174 PwCF were included (74 children, 43 teenagers and 57 adults). Home spirometry was used at least one time per week by 64.1 ± 4.9% PwCF, more frequently in children and teenagers than in adults (79.4 ± 2.9%, 69.2 ± 5.5% and 40.4 ± 11.5% respectively). The reliability to conventional lung function testing was good for all assessed parameters (e.g., FEV1: r = 0.91, p < 0.01) and the variability over the 6 months of observation was low (FEV1 coefficient of variation = 11.5%). For each parameter, reliability was better, and the variability was lower in adults than in teenagers than in childrenConclusionHome spirometry telemonitoring appears to be a reliable tool for multi-weekly lung function follow-up of PwCF.

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“…Bell et al. [2] performed a single-center prospective observational study comparing observed and unobserved home spirometry among 74 adults (mean age 37 years, SD 11; mean ppFEV 1 59) between February and December 2020. In contrast with Paynter et al., there was no ‘gold standard’ clinic spirometry, hence the study findings may be more difficult to interpret.…”

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confidence: 99%