A new, wireless home monitoring program designed to collect data on lung function from patients with idiopathic pulmonary fibrosis (IPF) in real time showed good results and was approved by patients in a Dutch pilot study.
Findings showed that spirometry measurements, which assess the amount and/or speed of air inhaled and exhaled, at home and in the hospital were similar, and patients considered the technology both useful and highly feasible.
Results of the study, conducted by researchers at Erasmus University Medical Center in Rotterdam, Netherlands, were published in the journal Respiratory Research, in the article, “A home monitoring program including real-time wireless home spirometry in idiopathic pulmonary fibrosis: a pilot study on experiences and barriers.”
IPF patients have limited home monitoring experiences, and such technologies are not yet implemented in daily care, although they have shown great potential for research and care by assisting with real-time and frequent data collection at home.
Handheld spirometers could potentially be used by IPF patients at home, but few studies have been conducted on their use. The studies that have been performed demonstrated the feasibility of these devices and their potential to promote a better disease prediction, but they were limited in terms of data collection and reliability because they used paper-based or central read-out of results.
To overcome some of these limitations, researchers tested a pre-developed, real-time, wireless, home spirometry monitoring program, called IPF-online, in IPF patients over four weeks.
In collaboration with patients, the team also tried to identify potential barriers and solutions for the implementation of the technology.
“IPF-online is a secured online personal platform, following European safety regulations,” the researchers wrote. “The program consists of daily home spirometry, online patient-reported outcomes (PROs) at baseline and after four weeks, weekly reporting of side-effects and symptoms on visual analogue scales, an information library, medication coach and eConsultations. The Bluetooth-enabled spirometer transmits data real-time via a secure encrypted connection, enabling patients and healthcare providers to access data directly.”
Ten IPF patients, with a mean age of 71 years, were asked to test the home monitoring program, including the daily home spirometer. All patients were on disease-modifying medication — 60 percent on Boehringer‘s Ofev (nintedanib) and 40 percent on Esbriet (pirfenidone), marketed by Genentech/Roche.
Measurements of forced vital capacity, or FVC, a measure of lung function, through spirometry at home and in the hospital were similar, with a median difference of 0.22 liters. Overall lower readings were registered at home.
Most of the patients — 80% — considered daily spirometry easy to use, and 90% said it was not burdensome. The mean adherence to home spirometry was 98.8%. All participants considered real-time spirometry useful, and would recommend it to others.
About 90% of the patients expressed the wish to continue home monitoring after the pilot study, saying it made them feel more in control of their disease.
Overall, “a home monitoring program including wireless home spirometry, is highly feasible and appreciated by patients with IPF, and enables real-time detection of change in FVC and PROs facilitating personalized care,” the researchers wrote.
Both researchers and patients also discussed relatively simple solutions for the potential barriers identified in using real-time home spirometry, namely, to provide patients with a smartphone or tablet with a 4G SIM card to overcome lack of an internet connection; provide patients with clear instructions and good training on how to use the application and the spirometer; and set realistic targets to boost the patient’s motivation and compliance.
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