The Long-Term Uptake of Home Spirometry in Regular Cystic Fibrosis Care: Retrospective Multicenter Observational Study
BackgroundHome 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 spirome...
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JMIR Publications
2025-01-01
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| Series: | Journal of Medical Internet Research |
| Online Access: | https://www.jmir.org/2025/1/e60689 |
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| author | 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 |
| author_facet | 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 |
| author_sort | Pia Bertram |
| collection | DOAJ |
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BackgroundHome 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.
ObjectiveWe aimed to gain insight into the long-term uptake of home spirometry in regular multicenter CF care.
MethodsHome spirometers combined with a remote monitoring platform were introduced in the treatment of people with CF in 5 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 tests 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, on use frequency over time was assessed in a subgroup of participants with repeated measures ANOVA.
ResultsDuring the observation period, a total of 604 people with CF were enrolled in the remote monitoring platform and 9930 home spirometry measurements were performed. After the initiation of home spirometry use, the number of users declined rapidly. One year after the initiation, 232 (54.2%) people with CF stopped using home spirometry. During the observation period, 67 (11.1%) users performed more than 20 measurements. Furthermore, the number of consistent home spirometry users decreased over time. After 600 days, only 1% of users had measured their lung function consistently every 31 days. Use frequency slightly increased during periods with increased pulmonary symptoms (ΔMean=0.45, t497.278=–4,197; P<.001) and showed an initial rise followed by a decrease after starting treatment with Elexacaftor/Tezacaftor/Ivacaftor (ΔMean=0.45, t497.278=–4,197; P<.001).
ConclusionsConsistent 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 the long-term uptake of home spirometry. Nevertheless, home spirometry and its intensity are not a goal on their own but should be used as a tool to reach individual goals within local contexts. |
| format | Article |
| id | doaj-art-fed9d019a1b34a9ea59cc87a0f5cc456 |
| institution | Kabale University |
| issn | 1438-8871 |
| language | English |
| publishDate | 2025-01-01 |
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| series | Journal of Medical Internet Research |
| spelling | doaj-art-fed9d019a1b34a9ea59cc87a0f5cc4562025-01-09T22:00:29ZengJMIR PublicationsJournal of Medical Internet Research1438-88712025-01-0127e6068910.2196/60689The Long-Term Uptake of Home Spirometry in Regular Cystic Fibrosis Care: Retrospective Multicenter Observational StudyPia Bertramhttps://orcid.org/0009-0002-4902-5877Martinus C Oppelaarhttps://orcid.org/0000-0002-8051-4161Michiel AGE Bannierhttps://orcid.org/0000-0003-4823-5872Monique HE Reijershttps://orcid.org/0000-0002-4401-5103Hester van der Vaarthttps://orcid.org/0009-0006-8755-2466Renske van der Meerhttps://orcid.org/0000-0003-1818-6360Josje Altenburghttps://orcid.org/0000-0002-7248-963XLennart Conemanshttps://orcid.org/0000-0002-2348-1826Bart L Rottierhttps://orcid.org/0000-0002-2437-8070Marianne Nuijsinkhttps://orcid.org/0000-0002-3948-2794Lara S van den Wijngaarthttps://orcid.org/0000-0002-4197-371XPeter JFM Merkushttps://orcid.org/0000-0002-1977-7384Jolt Roukemahttps://orcid.org/0000-0001-6971-7892 BackgroundHome 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. ObjectiveWe aimed to gain insight into the long-term uptake of home spirometry in regular multicenter CF care. MethodsHome spirometers combined with a remote monitoring platform were introduced in the treatment of people with CF in 5 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 tests 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, on use frequency over time was assessed in a subgroup of participants with repeated measures ANOVA. ResultsDuring the observation period, a total of 604 people with CF were enrolled in the remote monitoring platform and 9930 home spirometry measurements were performed. After the initiation of home spirometry use, the number of users declined rapidly. One year after the initiation, 232 (54.2%) people with CF stopped using home spirometry. During the observation period, 67 (11.1%) users performed more than 20 measurements. Furthermore, the number of consistent home spirometry users decreased over time. After 600 days, only 1% of users had measured their lung function consistently every 31 days. Use frequency slightly increased during periods with increased pulmonary symptoms (ΔMean=0.45, t497.278=–4,197; P<.001) and showed an initial rise followed by a decrease after starting treatment with Elexacaftor/Tezacaftor/Ivacaftor (ΔMean=0.45, t497.278=–4,197; P<.001). ConclusionsConsistent 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 the long-term uptake of home spirometry. Nevertheless, home spirometry and its intensity are not a goal on their own but should be used as a tool to reach individual goals within local contexts.https://www.jmir.org/2025/1/e60689 |
| spellingShingle | 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 The Long-Term Uptake of Home Spirometry in Regular Cystic Fibrosis Care: Retrospective Multicenter Observational Study Journal of Medical Internet Research |
| title | The Long-Term Uptake of Home Spirometry in Regular Cystic Fibrosis Care: Retrospective Multicenter Observational Study |
| title_full | The Long-Term Uptake of Home Spirometry in Regular Cystic Fibrosis Care: Retrospective Multicenter Observational Study |
| title_fullStr | The Long-Term Uptake of Home Spirometry in Regular Cystic Fibrosis Care: Retrospective Multicenter Observational Study |
| title_full_unstemmed | The Long-Term Uptake of Home Spirometry in Regular Cystic Fibrosis Care: Retrospective Multicenter Observational Study |
| title_short | The Long-Term Uptake of Home Spirometry in Regular Cystic Fibrosis Care: Retrospective Multicenter Observational Study |
| title_sort | long term uptake of home spirometry in regular cystic fibrosis care retrospective multicenter observational study |
| url | https://www.jmir.org/2025/1/e60689 |
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