The Use of Home Spirometry in Pediatric Cystic Fibrosis Patients

Abstract

Medication adherence is poor among pediatric cystic fibrosis (CF) patients, with adolescents having one of the lowest adherence rates. We wanted to identify an adherence intervention that would be acceptable to CF adolescents and assess its feasibility. We surveyed 40 adolescents with CF and asked about barriers to and motivators for their own adherence and to generate ideas for potential adherence interventions. Since most of the respondents chose frequent spirometry at home and medication reminders for interventions, we selected 5 subjects, 10 to 14 years of age, with CF to test the feasibility of home spirometry and medication reminders in pediatric CF patients. This article summarizes the results of both the survey and the feasibility pilot study.

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

“…They were also able to maintain the weekly monitoring for a full year, similar to the adults in the Lechtzin et al study. A pilot study of the Spiro PD® device demonstrated that it could be successfully used by patients with CF as young as 11 years of age . Although the training time of 29 min might not be feasible in a busy clinic setting, the participants were trained in the PFT lab after their clinic visit.…”

“…Barriers to medication adherence among adolescents with CF include forgetfulness, competing time pressures, and doubts about the necessity, or usefulness of the prescribed treatment regimen . There is a decline in parental supervision during adolescence, which has been shown to negatively impact treatment adherence in this group .…”

“…Many of the same studies that elicited the aforementioned barriers have also identified multiple adherence motivators such as recognition of the impact of non‐adherence on health outcomes, a strong relationship with the CF care team and encouragement from friends and family . Interventions that promote self‐management skills, whether they be a knowledge‐based intervention such as providing more education about the disease process and available treatments, or a behavioral intervention like motivational interviewing, appear to improve medication adherence in individuals with CF .…”

“…Reviewing PFT results appear to be an adherence motivator for many adolescents and young adults . Home PFT monitoring has enabled clinicians to obtain more frequent data and allows patients the opportunity to readily review and keep track of the results .…”

“…Reviewing PFT results appear to be an adherence motivator for many adolescents and young adults . Home PFT monitoring has enabled clinicians to obtain more frequent data and allows patients the opportunity to readily review and keep track of the results . Lechtzin et al conducted a large, randomized controlled trial evaluating the benefits of early detection of pulmonary exacerbations on PFT in adults with CF (mean age of 27 years).…”