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Clinical outcomes of digital health in adults with cystic fibrosis - 23/09/22

Doi : 10.1016/j.rmed.2022.106970 
Vincenzo Carnovale a, 1 , Paola Iacotucci a, 1 , Dandi Qiao b , Lorenza Ferrillo a , Jolanda Somma a , Serena Buonaurio a ,  Marcella d’Ippolito a , Assunta Celardo a , Daniela Savi c,
a Department of Translational Medical Science, “Federico II” University of Naples, Italy 
b NuvoAir U.S. Inc, Boston, MA, USA 
c Department of Public Health and Infectious Diseases, “Sapienza” University of Rome, Italy 

Corresponding author. Department of Public Health and Infectious Diseases, Sapienza University of Rome, 00185 Rome, Italy.Department of Public Health and Infectious DiseasesSapienza University of RomeRome00185Italy

Abstract

Background

The aim of this study was to assess the long-term clinical impact of the application of e-health as part of a virtual model of care in patients with Cystic Fibrosis (CF).

Methods

Digital care group (DCG) were deemed suitable for using the NuvoAir Home platform to monitor their disease at home as part of a virtual model of care project. The usual care group (UCG) remained on usual care. NuvoAir Home platform consists of a smartphone application, Bluetooth spirometer and a clinician portal. Data on pulmonary function, Cystic Fibrosis Questionnaire–Revised (CFQR) and pulmonary exacerbations were collected at baseline and after twelve months. A survey for the digital care group was emailed to evaluate their experience using the technology.

Results

Between February 2020 and May 2020 a cohort of 43 CF patients were recruited for the DCG (26 females; mean age 31.6 ± 6.8; 16 homozygous for delta F508; FEV1 48.4 ± 16.3% predicted) and 36 CF patients for UCG (18 females; mean age 29.1 ± 9.4; 6 homozygous for delta F508; FEV1 77.0 ± 25.0% predicted). CFQ-R score improved significantly through 12 months in the DCG with a mean change of 13.8 points, p < 0.0001, and no changes for the UCG (p = 0.73). When we analyzed the subgroup of CF patients on digital and usual care who did not receive CFTR modulator therapy, we found a change in CFQ-R score which was significantly associated with the use of digital technology while adjusting for baseline differences (p = 0.020). There was no significant difference in the change in lung function and number of exacerbations. 90% of patients reported they understood their CF better using the NuvoAir Home platform. No changes in medical treatment were reported during that time.

Conclusions

The application of digital technologies in the management of adults with CF showed an improvement in patients’ quality of life. Using a virtual model of care was well accepted by CF patients and improved their understanding of their medical condition.

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Highlights

It is important to assess clinical effects provided by the application of e-health in CF.
Digital technologies in CF showed an improvement in patients' quality of life.
The virtual model was well accepted, enabling patients to understand trends in their health status.
The virtual model supported clinician and patient confidence in decision making.
Our results will help clinicians to plan future directions for CF management.

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Keywords : Cystic fibrosis, Digital health, Longer-term telehealth benefits, Virtual monitoring

Abbreviations : CF, BMI, FEV1, CFQ-R, pwCF


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Vol 202

Article 106970- octobre 2022 Retour au numéro
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