The feasibility of home monitoring of young people with cystic fibrosis: Results from CLIMB-CF

Edmondson, C.; Westrupp, Nicole; Seddon, Paul; Olden, Catherine; Wallis, Colin; Dawson, C.; Brodlie, Malcolm; Baxter, F.; McCormick, Jonathan; Macfarlane, Sandra; Rice, Danielle B; MacLeod, Alison J.; Brooker, Richard; Connon, M.; Ghayyda, Salim N.S.; Blaikie, L.; Thursfield, Rebecca; Brown, Laura E.; Price, April; Fleischer, E.; Itterman, Jennifer; Hughes, Daniel; Barrett, P. K. M.; Surette, Michael G.; Donnelly, Christine; Mateos-Corral, Dimas; Padley, George; Wallenburg, J.; Brownlee, K.; Alton, Ewfw; Bush, Andy; Davies, Jane C.

doi:10.1016/j.jcf.2021.09.018

Cited by 22 publications

(20 citation statements)

References 27 publications

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“…[8][9][10] During the pandemic, CF centers described challenges with device set-up, adherence and user technique. 5,11 As many PwCF now have access to home spirometers, understanding the feasibility of home spirometry in the chronic CF care model is needed. We hypothesized that it may be feasible for children and adults with CF to use two different home spirometers with the latest technological features (Bluetooth connection and wireless data transfer) over a short period.…”

mentioning

confidence: 99%

Real‐world feasibility of short‐term, unsupervised home spirometry in CF

Davis

Ryan

Marchetti

et al. 2022

Pediatric Pulmonology

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Objectives: The objective of this study was to study the performance of two available home spirometers used by people with Cystic Fibrosis (PwCF) over a shortterm period and to assess user experience. Study design: This was a prospective observational study. Participants age 6 years and older were recruited to participate if they could complete acceptable spirometry in the clinic setting. Methods: Participants used either the NuvoAir Air Next or the ZEPHYRx MIR Spirobank Smart spirometer. They underwent a one-time virtual training session, then completed 2 weeks of daily spirometry followed by 2 months of weekly spirometry. Participants responded to surveys and completed a debrief interview to understand user experience. Statistical analyses examined feasibility, reliability, and accuracy of each spirometer in an unsupervised, real-world setting.Results: We report high adherence (80% [95% CI 61%-92%]) to our study protocol in all session attempts, but lower rates of adherence after discarding sessions performed with inadequate technique (47% [95% CI 28%-66%] to 63% [95% CI 44%-80%]). We found high reliability of each device by analyzing day-to-day variability and good concordance to recent in-clinic testing (NuvoAir r = 0.91 [0.82-0.93]; ZEPHYRx r = 0.70 [0.45-0.84]). Patient experience in this cohort was favorable with most reporting ease of use and reassurance knowing lung function was being tracked over time. Conclusions: This real-world study showed good performance of two different available home spirometers used by children and adults with CF. While overall adherence was high, suboptimal technique reduced the total interpretable data, possibly limiting feasibility. Future work should focus on developing sustainable training and coaching programs to support the success of home spirometry in a CF chronic care model.

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confidence: 99%

Real‐world feasibility of short‐term, unsupervised home spirometry in CF

Davis

Ryan

Marchetti

et al. 2022

Pediatric Pulmonology

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“…A widespread surge in ‘tele’ or digital health has occurred [ 6 , 7 ]. In general, this has been reasonably successfully implemented and accepted by PwCF and care providers, particularly adults [8] , [9] , [10] , [11] , [12] . Health care providers and PwCF have adapted to home spirometry, remote microbiological sample collection, blood monitoring and video consultants well [ 7 , 10 , 13 ].…”

Section: Impact Of Covid-19 On Clinical Carementioning

confidence: 99%

“…Other disadvantages include the lack of ability to perform a physical examination, difficulties in microbiological surveillance, and the loss of subtleties in communication that may get lost without face to face contact, particularly where there is a language barrier [ 7 , [9] , [10] , [11] , [12] , [14] , [15] , [16] ]. Pediatric teams and parents have been less likely to advocate for remote consultations and have raised concerns regarding monitoring adherence, safeguarding issues, and engaging teenagers [ 8 , 9 , 12 , 14 ]. Disparities in high speed internet access and technology may create a ‘digital divide' [ 9 , 12 , 17 ].…”

Section: Impact Of Covid-19 On Clinical Carementioning

confidence: 99%

A year in review: Real world evidence, functional monitoring and emerging therapeutics in 2021

Barr

Bihouée²,

Zwitserloot

2022

Journal of Cystic Fibrosis

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“…There has been a drive to provide some portion of CF clinical care through remote clinic consultations and monitoring [51,52]; this impetus has been accelerated during the COVID-19 pandemic [31,32 ▪▪ ,33,34 ▪▪ ]. Tools for remote electronic data capture, including weight, spirometry, oxygenation, physical activity measurements, diabetes control, are becoming increasingly used to provide objective monitoring of health status for people with CF and, whilst generally well received, challenges remain, particularly during teenage years [53]. A remote consultation with no physical contact with a healthcare facility will not incur any risk of nosocomial transmission of CF pathogens, but may lead to a reduction in overall collection of lower respiratory samples for microbiological surveillance, that may be further impacted by the new era of CFTR modulation therapy.…”

Section: Implications Of Increasing Use Of New Digital Technology For...mentioning

confidence: 99%

Infection control in cystic fibrosis: evolving perspectives and challenges

Jones¹

2022

Current Opinion in Pulmonary Medicine

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Purpose of reviewThis article reviews the impact of some of the most recent changes in clinical care management in cystic fibrosis on infection prevention practice and advice for people with cystic fibrosis. Recent findingsPeople with cystic fibrosis (CF) consistently highlight infection control as one of their major concerns. Infection prevention guidance and practice has facilitated successful decreases in rates of many transmissible CF pathogens. The coronavirus disease 2019 pandemic highlighted the clinical significance of respiratory viral infections and has accelerated the implementation of remote monitoring and telemedicine consultations as standard practice in CF. The continued improvement in health of the CF population is being further augmented by the introduction of new therapies, in particular cystic fibrosis transmembrane conductance regulator modulators. Infection prevention will remain pertinent to CF care, but these recent changes in clinical practice will have ongoing implications for infection prevention guidance in CF. SummaryRecent changes in CF clinical care have implications that will lead to further evolution of infection control practice and advice.

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The feasibility of home monitoring of young people with cystic fibrosis: Results from CLIMB-CF

Cited by 22 publications

References 27 publications

Real‐world feasibility of short‐term, unsupervised home spirometry in CF

Real‐world feasibility of short‐term, unsupervised home spirometry in CF

A year in review: Real world evidence, functional monitoring and emerging therapeutics in 2021

Infection control in cystic fibrosis: evolving perspectives and challenges

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