JMIR Publications

ABSTRACT

Background:

Home spirometry has been widely adopted in the delivery of cystic fibrosis (CF) care. While existing literature largely supports its feasibility and positive outcomes, behaviour around home disease monitoring remains poorly understood.

Objective:

This study aimed to evaluate healthcare professionals’ (HCPs') ability to estimate home spirometry usage pwCF and compare these with actual recorded data.

Methods:

Home spirometry data, from a single large adult CF centre, for the year 2024, was obtained from NuvoAir. HCPs (doctors, nurses, and physiotherapists) rated their familiarity with each pwCF and categorised them as infrequent, expected, or highly frequent spirometry users. They were also asked to estimate spirometry usage as an open-ended numerical response. CF experience was defined by the number of years the HCP had worked at the centre. Estimation accuracy was assessed using mean bias and mean absolute error (MAE).

Results:

10 doctors (35.7%), 6 nurses (21.4%), and 12 physiotherapists (42.9%) responded to the survey, with an overall response rate of 96.6%. There were 790 completed categorical estimates and 794 numerical estimates. The mean (±SD) CF experience was 15.7 (±8.2) years. Across all roles, HCPs systematically underestimated home spirometry usage (mean bias -4.9; MAE 6.32). No significant differences in estimation accuracy were observed based on professional role, reported familiarity or CF experience.

Conclusions:

This study found that CF caregivers tend to underestimate home spirometry usage, in contrast to other studies showing they often overestimate treatment adherence. This highlights gaps in understanding behaviour in pwCF and the need for CF teams to adapt to evolving models of remote monitoring.