Clinic vs Home Spirometry for Monitoring Lung Function in Patients With Asthma

Oppenheimer, John; Hanania, Nicola A.; Chaudhuri, Rekha; Sagara, Hironori; Bailes, Zelie; Fowler, Andrew; Peachey, Guy; Pizzichini, Emílio; Slade, David

doi:10.1016/j.chest.2023.06.029

Cited by 10 publications

(3 citation statements)

References 25 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…We recognise a limitation of portable DS devices is the tendency to under read overall lung volumes ( i.e. FVC measures) in comparison to lab-based results [ 22 ]. In our cohort, despite physiologist input, it is likely that FVC measurements may be lower than results performed in a laboratory setting, as we cannot truly verify that full patient effort occurred during the manoeuvre retrospectively.…”

Section: Discussionmentioning

confidence: 99%

Feasibility and value of a domiciliary spirometry programme in the assessment of severe asthma: a real-world evaluation

Williams,

Hull,

et al. 2023

ERJ Open Res

View full text Add to dashboard Cite

BackgroundDomiciliary spirometry (DS) is a novel tool that is widely employed in the assessment of respiratory disease. We assessed real-world feasibility, effectiveness and value of a physiologist-led home spirometry programme in patients with treatment-refractory severe asthma.MethodsPatients were referred and provided with a hand-held DS device. Patients completed baseline measurements in a physiologist-led virtual clinic and were instructed to provide further values during any periods of respiratory symptoms. Outcome measures included prevalence of new obstructed events, DS adherence and uptake of this approach.Results112 patients were enrolled from November 2020 to January 2023. 102 individuals, mean±sdage 44±13 years (86% female) with median (IQR) forced expiratory volume in 1 s % predicted 88% (77–97%), successfully recorded baseline spirometry values. During follow-up (24 months), 11 (11%) were identified with new obstructive spirometry and were subsequently able to be commenced on biologic therapy. Patient engagement was poor with median (IQR) of 4 (2–6) attempts of contact made before baseline values were recorded, and 2 (1–3) attempts required to record technically acceptable values. Continued DS use was suboptimal; 34% failed to use their device after baseline and only 10% continued at the end of the study period. The cost of DS measurements was greater than a single hospital-based visit but enables multiple event capture.ConclusionOverall, DS measurement uptake was poor, with a minority of patients continuing to use the device at the end of the study period. However, for those that engage, DS provides an alternative approach to traditional hospital-based spirometry measurements that can alter clinical management.

show abstract

Section: Discussionmentioning

confidence: 99%

Feasibility and value of a domiciliary spirometry programme in the assessment of severe asthma: a real-world evaluation

Williams,

Hull,

et al. 2023

ERJ Open Res

View full text Add to dashboard Cite

show abstract

“…Two recent articles were published comparing unsupervised home spirometry and clinic spirometry, a meta-analysis by Anand et al 10 and a post hoc analysis by Oppenheimer et al 11 , both concluding that home spirometry is less consistent than and lacked agreement with clinic spirometry, suggesting that unsupervised home readings are not interchangeable with clinic measurements. Nevertheless, the meta-analysis by Anand et al 10 included studies of all clinical conditions, with significant heterogeneity among outcomes, while we focused on asthma patients, who seem to be ideal candidates for such an intervention.…”

Section: Discussionmentioning

confidence: 99%

“…Nevertheless, the meta-analysis by Anand et al 10 included studies of all clinical conditions, with significant heterogeneity among outcomes, while we focused on asthma patients, who seem to be ideal candidates for such an intervention. Furthermore, different portable devices were used in the studies included in the meta-analysis and the study by Oppenheimer et al 11 , thus the results may only apply to those specific spirometers.…”

Section: Discussionmentioning

confidence: 99%

Achievement of high-quality home spirometry in patients with asthma: The NuvoAir platform

Potonos,

Exarchos,

Assioura

et al. 2023

Pneumon

View full text Add to dashboard Cite

INTRODUCTIONSelf-monitoring has a recognized place in achieving asthma control. Traditionally, patients record symptoms and peak flow measurement in a paper diary, which they use to adjust therapy in accordance with written asthma plans. Telemonitoring augments disease management by facilitating patients to record their level of asthma control electronically, supporting remote physician consultations. This study evaluated the quality of home-based spirometry in asthma using the NuvoAir platform (NuvoAir U.S inc, Boston, M.A., U.S.A.), which consists of a smartphone application, Bluetooth spirometer (AirNext), and physician portal. METHODS Consecutive adults with difficult-to-treat or severe asthma were trained on the AirNext, and were asked to perform home spirometry daily for the first month and then weekly or on symptom worsening. These analyses used data from patients who performed their first unsupervised spirometry within 30 days of their supervised. The grading of the quality of spirometry sessions was based on the American Thoracic Society Technical Statement. RESULTS A total of 10 patients with asthma (four uncontrolled asthma; six partly controlled [GINA 2018]) were included in this study, 9 (90%) female, mean age 42.0 ± 10.7 years, with FEV1 69.6 ± 26.2% (range: 27.3-101.0) predicted at the supervised session. Patients performed 1235 unsupervised sessions over 181.5 ± 153.9 days (maximum 382 days), 877 (71.0%) of which were acceptable quality, the majority of these (556) being Grade A. CONCLUSIONS Overall our data show that unsupervised home spirometry can provide high quality results. More studies are needed to assess home unsupervised spirometry in larger populations and determine whether it may lead to improved patient outcomes.

show abstract