Evaluation of a home telemonitoring service for adult patients with cystic fibrosis: a pilot study

Grzincich, G.L.; Gagliardini, R.; Bossi, Anna; Bella, Sergio; Cimino, Giuseppe; Cirilli, N.; Viviani, Laura; Iacinti, E.; Quattrucci, Serena

doi:10.1258/jtt.2010.091006

“…Grzincich G. et al . conducted a pilot trial of a home telemonitoring system with spirometry and oxygen saturation involving 30 randomly selected adults with CF, showing that telemonitoring was useful in assessing the patients’ health status and in decreasing the CF centre workload 17 . An economic analysis of home telemonitoring in CF patients for a follow-up period of 10 years was performed by Tagliente I. and coworkers.…”

Section: Discussionmentioning

confidence: 99%

Early detection of pulmonary exacerbations in children with Cystic Fibrosis by electronic home monitoring of symptoms and lung function

Horck

¹

,

Winkens

²

,

Wesseling

³

et al. 2017

Sci Rep

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Pulmonary exacerbations (PEx) in Cystic Fibrosis (CF) are associated with an increased morbidity and even mortality. We investigated whether early detection of PEx in children with CF is possible by electronic home monitoring of symptoms and lung function. During this one-year prospective multi-centre study, 49 children with CF were asked to use a home monitor three times a week. Measurements consisted of a respiratory symptom questionnaire and assessment of Forced Expiratory Volume in one second (FEV1). Linear mixed-effects and multiple logistic regression analyses were used. In the 2 weeks before a PEx, the Respiratory Symptom Score (RSS) of the home monitor increased (p = 0.051). The FEV1 as percentage of predicted (FEV1%pred) did not deteriorate in the 4 weeks before a PEx. Nevertheless, the FEV1%pred at the start of exacerbation was significantly lower than the FEV1%pred in the non-exacerbation group (mean difference 16.3%, p = 0.012). The combination of FEV1%pred and RSS had a sensitivity to predict an exacerbation of 92.9% (CI 75.0–98.8%) and a specificity of 88.9% (CI 50.7–99.4%). The combination of home monitor FEV1%pred and RSS can be helpful to predict a PEx in children with CF at an early stage.

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“…Later extensions of this work demonstrated the ability of patients to transmit the results of their home spirometry to the CF clinic via computer modem . Other forms of telemedicine have also been evaluated but efficacy data are lacking to support its use in CF . Currently, an ongoing multicenter study (the early Intervention in CF Exacerbation study [eICE Study]) is assessing the role of home spirometry and symptom monitoring to identify and manage pulmonary exacerbations in adolescents and adults with CF .…”

Section: Tackling the Solutions: Integration Of Technologies To Cf Thmentioning

confidence: 99%

Tackling the increasing complexity of CF care

Sawicki

¹

,

Goss

²

2015

Pediatric Pulmonology

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Summary Health outcomes for individuals with cystic fibrosis (CF) have dramatically improved in parallel with better organization of clinical care systems, evolution of novel therapeutics, and improvements in diagnosis and screening for CF and CF‐related complications. In parallel with these advances has come an increasing complexity and burden of care, leading to challenges with adherence to treatment regimens. As novel therapeutics continue to be developed and introduced to the CF care regimen, there are clear opportunities to refine and personalize care. This can be done by adding comparative effectiveness research to the CF clinical research paradigm and integrating novel technologies in drug delivery and remote monitoring that can facilitate adherence but also reduce the burden of treatment while maintaining efficacy. This review highlights both the challenges of the increasingly complex treatment regimens in CF and the opportunities to advance care by addressing adherence, implementation science, comparative effectiveness, and integration of novel technologies in CF care. Pediatr Pulmonol. 2015; 50:S74–S79. © 2015 Wiley Periodicals, Inc.

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“…However, the results of this trial have not been published yet. Grzincich G. et al conducted a pilot trial of a home telemonitoring system with spirometry and oxygen saturation involving 30 randomly selected adults with CF, showing that telemonitoring was useful in assessing the patients' health status and in decreasing the CF centre workload 17 . An economic analysis of home telemonitoring in CF patients for a follow-up period of 10 years was performed by Tagliente I. and coworkers.…”

Section: Discussionmentioning

confidence: 99%

Early detection of pulmonary exacerbations in children with cystic fibrosis by electronic home monitoring of symptoms and lung function

Dompeling

¹

,

Horck

²

,

Winkens³

et al. 2016

7.3 Cystic Fibrosis

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Pulmonary exacerbations (PEx) in Cystic Fibrosis (CF) are associated with an increased morbidity and even mortality. We investigated whether early detection of PEx in children with CF is possible by electronic home monitoring of symptoms and lung function. During this one-year prospective multicentre study, 49 children with CF were asked to use a home monitor three times a week. Measurements consisted of a respiratory symptom questionnaire and assessment of Forced Expiratory Volume in one second (FEV1). Linear mixed-effects and multiple logistic regression analyses were used. In the 2 weeks before a PEx, the Respiratory Symptom Score (RSS) of the home monitor increased (p = 0.051). The FEV1 as percentage of predicted (FEV1%pred) did not deteriorate in the 4 weeks before a PEx. Nevertheless, the FEV1%pred at the start of exacerbation was significantly lower than the FEV1%pred in the non-exacerbation group (mean difference 16.3%, p = 0.012). The combination of FEV1%pred and RSS had a sensitivity to predict an exacerbation of 92.9% (CI 75.0-98.8%) and a specificity of 88.9% (CI 50.7-99.4%). The combination of home monitor FEV1%pred and RSS can be helpful to predict a PEx in children with CF at an early stage.Pulmonary exacerbations in Cystic Fibrosis (CF) are important events, associated with an accelerated decline in lung function and an increased morbidity and even mortality 1 . Prevention of pulmonary exacerbations (PEx) is one of the main goals in the management of CF 2 . Currently, treatment of a PEx starts when a patient presents with an increase in (respiratory) complaints, a deterioration in lung function and/or weight loss. It often takes some time before a patient with more complaints seeks medical care. This patient delay may introduce a subsequent delay in starting antibiotic treatment, potentially resulting in a more severe course of the PEx, and a higher risk of permanent lung function loss.There are some known risk factors for PEx in children, including frequency of previous PEx, a lower baseline Forced Expiratory Volume in one second (FEV 1 ), and female sex 3 . However, in individual cases these factors do not help to decide when to start therapy timely. As PEx cannot be predicted reliably yet, there is a need for a method to detect PEx at an earlier stage. Electronic home monitoring may be useful to detect changes in lung function and respiratory complaints at an early stage. It provides the opportunity to assess symptoms and lung function on a daily or weekly basis. Data can be sent to the CF centre where they can be evaluated. In this way, disease deterioration and the occurrence of PEx may be detected earlier.

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Evaluation of a home telemonitoring service for adult patients with cystic fibrosis: a pilot study

Cited by 35 publications

References 8 publications

Early detection of pulmonary exacerbations in children with Cystic Fibrosis by electronic home monitoring of symptoms and lung function

Early detection of pulmonary exacerbations in children with Cystic Fibrosis by electronic home monitoring of symptoms and lung function

Tackling the increasing complexity of CF care

Early detection of pulmonary exacerbations in children with cystic fibrosis by electronic home monitoring of symptoms and lung function

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