Telehealth spirometry for children with cystic fibrosis

Abstract

AimWe assessed the feasibility of telehealth spirometry assessments for children with cystic fibrosis (CF) living in a regional setting.MethodPatients with acceptable computer hardware at home were provided with a SpiroUSB (Vyaire) spirometer. Spirometry was performed during ‘home admissions’ or for ongoing home monitoring in children living outside metropolitan Melbourne. At the end of the session, the family forwarded the data to the Royal Children’s Hospital, Melbourne.ResultsTwenty-two patients aged 7 to 17 years participated, with spirometry successful in 55 of 59 (93%) attempted sessions according to American Thoracic Society/European Respiratory Society criteria. The median distance between the subject’s home and the hospital was 238 km (range 62–537 km) which equated to a travel time saving of 5 hours and 34 min per hospital visit.ConclusionHome-based telehealth spirometry is feasible in children with CF and can support the CF team during home-based admissions and for ongoing outpatient monitoring.

Patient and family perspectives regarding the use of telehealth for cystic fibrosis care

“…Telehealth clinics hold many potential benefits for people with CF and their families which could address the negative aspects of in‐person clinics. Attending appointments from home or work would result in less interruption to daily life and reduced travel time, with associated financial savings 1 . In addition, the risk of cross infection at the time of clinic visits would be eliminated.…”

“…Limited data exist regarding telehealth in CF multidisciplinary clinics, and these studies have focused on feasibility 2 . For example, our centre demonstrated the feasibility of telehealth spirometry 1 . However, patient and family satisfaction with a telehealth model of care has received limited attention.…”

“…In addition, before the appointment, families were sent kits for obtaining airway samples including written instructions and a link to video demonstrations, and were asked to complete anthropometric measurements. Based on the success of the previous pilot study, 1 home spirometers were allocated to selected patients. Home spirometry assessments were supervised by a respiratory scientist as previously described 1 .…”

“…Based on the success of the previous pilot study, 1 home spirometers were allocated to selected patients. Home spirometry assessments were supervised by a respiratory scientist as previously described 1 . To assess family satisfaction with telehealth clinics, a specifically designed survey was distributed to families electronically 3.5 months after the transition to telehealth clinics.…”

Rapid Implementation of Telehealth Services in a Pediatric Pulmonary Clinic During COVID-19

“…Some of these missing assessments may be supplanted, at least in part, by novel home monitoring devices including pulse oximeters, virtual stethoscopes, and recently FDA-approved home spirometry devices, which may significantly add to the assessment we are able to make virtually. 19,20 Our division has initiated a home spirometry monitoring program in an attempt to partially fill this gap in virtual assessment, with plans to formally study the program's outcomes. Each specialty clinic will ultimately need to define standards of care regarding integration of telehealth into their clinical care model.…”