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Bertram P, Oppelaar MC, Bannier MA, Reijers MH, van der Vaart H, van der Meer R, Altenburg J, Conemans L, Rottier BL, Nuijsink M, van den Wijngaart LS, Merkus PJ, Roukema J
The Long-Term Uptake of Home Spirometry in Regular Cystic Fibrosis Care: Retrospective Multicenter Observational Study
The long-term uptake of home spirometry in regular cystic fibrosis care: A retrospective multicenter observational study
Pia Bertram;
Martinus C Oppelaar;
Michiel AGE Bannier;
Monique HE Reijers;
Hester van der Vaart;
Renske van der Meer;
Josje Altenburg;
Lennart Conemans;
Bart L Rottier;
Marianne Nuijsink;
Lara S van den Wijngaart;
Peter JFM Merkus;
Jolt Roukema
ABSTRACT
Background:
Home spirometers have been widely implemented in the treatment of people with Cystic Fibrosis (CF). Frequent spirometry measurements at home could lead to earlier detection of exacerbations. However, previous research indicates that the long-term use of home spirometry is not well maintained by people with CF.
Objective:
We aimed to gain insight into the long-term uptake of home spirometry in regular multicenter CF care.
Methods:
Home spirometers combined with a remote monitoring platform (RMP) were introduced in the treatment of people with CF in five Dutch CF centers starting in April 2020. Usage data from April 2020 to December 2022 were analyzed retrospectively. Survival analyses were conducted to assess use consistency over time, and t test were used to evaluate the impact of increased pulmonary symptoms on home spirometry frequency. The effect of the initiation of a new treatment (Elexacaftor/Tezacaftor/Ivacaftor (ETI)) on use frequency over time was assessed in a subgroup of participants with a repeated measures ANOVA.
Results:
During the observation period, a total of 604 people with CF were enrolled in the RMP. After the initiation of home spirometry use, the number of consistent home spirometry users declined rapidly. Use frequency slightly increased during periods with increased pulmonary symptoms (ΔMean= 0.45, t(497.278)= - 4,197 P<.0001) and showed an initial rise followed by a decrease after starting ETI treatment.
Conclusions:
Consistent uptake of home spirometry in people with CF is low but increases around periods of changing symptoms. A clear strategy for the organization of remote care seemed to improve long-term uptake of home spirometry. Nevertheless, home spirometry and its intensity are not a goal on its own but should be used as a tool to reach individual goals within local contexts.
Citation
Please cite as:
Bertram P, Oppelaar MC, Bannier MA, Reijers MH, van der Vaart H, van der Meer R, Altenburg J, Conemans L, Rottier BL, Nuijsink M, van den Wijngaart LS, Merkus PJ, Roukema J
The Long-Term Uptake of Home Spirometry in Regular Cystic Fibrosis Care: Retrospective Multicenter Observational Study