Education and implementation of home spirometry in an adolescent cystic fibrosis population - 19/09/23
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Highlights |
• | During the COVID-1 pandemic, a structured curriculum for home spirometry implementation and training was established at a single CF care Center, which was delivered by a dedicated CF respiratory therapist. |
• | Most adolescents who completed the training sessions were able to establish reliable technique and provide accurate and consistent results on the home spirometer. Some required additional training sessions. |
• | A dedicated CF respiratory therapist, who delivered training both in-person and remotely, with ongoing close follow-up, was essential to the success of this program. |
• | A portion of adolescents did not complete initial training or stay engaged to establish reliable technique. Future studies are needed to gain insight into barriers to ongoing engagement in an adolescent population. |
Abstract |
Background |
Lung function in individuals with cystic fibrosis (CF) is closely monitored as an objective marker of clinical status. The COVID-19 pandemic shifted our ability to assess individuals from in-person to remote monitoring using telehealth. As part of efforts to monitor individuals remotely during this time, this study describes the process of education and implementation of home spirometry in an adolescent CF population at Nemours Children's Hospital in Wilmington, Delaware, USA. In addition, this study reviews the ability of adolescents with CF to produce reliable, consistent, and accurate results using home spirometry.
Methods |
This was a quality-improvement study over a 9-month period at a single CF center. Home spirometers were supplied by the CF Foundation to 40 adolescents with CF. An educational curriculum was used for initial training on the device by a dedicated CF respiratory therapist. After training, participants reported spirometry results weekly until reliable technique was established. Once reliable technique was achieved, participants reported results monthly. Results were retrospectively reviewed to determine accuracy and consistency. The percentages of patients who were able to achieve reliable, consistent, and accurate results were recorded as well as the need for additional training or other reasons for inability to produce ongoing results.
Results |
Home spirometers were distributed to 40 adolescents. Out of these 40 participants, 35 (88%) completed initial training; 29 (83%) sent at least one set of results, and 24 (60%) established reliable technique after an average of 5 weekly attempts. When home spirometer results were retrospectively reviewed, 83% (20/24) were deemed accurate in comparison to spirometry completed in clinic, and 83% (20/24) showed consistency between efforts sent.
Conclusion |
Home spirometry, when properly implemented with structured education and active participant engagement, has potential to provide meaningful data and feedback to CF care teams. Implementation of this process requires substantial resources and active participation from an adolescent population who are at higher risk for non-adherence. Future studies are needed to determine the impact of home spirometry on clinical outcomes and reliability over time and to address barriers to consistent and enduring engagement in the adolescent population.
Le texte complet de cet article est disponible en PDF.Keywords : Home spirometry, Cystic fibrosis, Remote monitoring, Telemedicine, Adolescent
Plan
Vol 84
Article 101040- novembre 2023 Retour au numéroBienvenue sur EM-consulte, la référence des professionnels de santé.
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