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- Volume 83,Issue Suppl 1
- POS0745 RHEUM FOR EMPOWERMENT: FEASIBILITY AND PATIENTS’ PERCEPTION OF HOME MONITORING FOR CONNECTIVE TISSUE DISEASE RELATED INTERSTITIAL LUNG DISEASE
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Other connective tissue diseases
POS0745 RHEUM FOR EMPOWERMENT: FEASIBILITY AND PATIENTS’ PERCEPTION OF HOME MONITORING FOR CONNECTIVE TISSUE DISEASE RELATED INTERSTITIAL LUNG DISEASE
- W. L. Ng1,
- D. Howard1,
- L. Durcan1,
- K. Hurley2
- 1Beaumont Hospital, Rheumatology, Dublin, Ireland
- 2Beaumont Hospital, Medicine, Dublin, Ireland
Abstract
Background: Home spirometry monitoring has been shown to be a valuable tool in monitoring disease activity in patients with idiopathic pulmonary fibrosis (IPF)[1,2]. Little is known about its feasibility and challenges posed for patients with connective tissue diseases related interstitial lung disease (CTD-ILD) who often face impediments due to impaired hand function and Raynaud’s phenomenon, in addition to their respiratory symptoms.
Objectives: We explored the acceptability and feasibility of home spirometry and oximetry in patients with CTD-ILD and compared these to patients with IPF.
Methods: Patients with CTD-ILD and IPF as controls were recruited from a tertiary referral center in an observational cohort study. Patients were provided a portable handheld spirometer (MIR Spirobank Smart) and a Nonin finger oximeter linked to a smartphone app, and patients were educated on its use. Spirometry and oximetry readings were collated. A survey was conducted at 6 months to assess patients’ perception of home monitoring.
Results: Thirty-six patients with CTD-ILD and 47 with IPF were recruited and followed up for 6 months. The median ages were 65 and 71 years respectively (Table 1). According to our survey, 12 (33%) patients in the CTD-ILD cohort and 6 (13.04%) in the IPF cohort reported difficulty obtaining accurate oxygen levels due to cold fingers (p=0.045). Only 6 (17%) from the CTD-ILD cohort but none from the IPF cohort experienced difficulty using the devices due to hand problems (p=0.01). The reported barriers to long-term remote monitoring were forgetting to use the devices, occasional cough or breathlessness (Figure 1). Anxiety contributed by home monitoring results was outlined in less than one-third of our patients. 64% (21/36 vs 32/47) preferred in-person consultations with their doctors rather than virtual consultations. A majority of patients found home monitoring beneficial and insightful, and would recommend this to others.
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Table 1.
Baseline demographics of study patients (n=83) and six-month data on home monitoring
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Figure 1.
Charts demonstrating (i) Ease of using home monitoring app and devices between patients with CTD-ILD and IPF; (ii) Reasons for not using the home monitoring devices regularly; (iii) Patients’ perception of the usefulness of monitoring their breathing.
Conclusion: Perception towards home spirometry and oximetry monitoring in our cohort was overall positive. Our findings indicated that home monitoring is feasible, acceptable and well-received in patients with CTD-ILD. Remote monitoring should be strongly considered in patients with CTD-ILD as part of standard care.
REFERENCES: [1] Russell AM, Adamali H, Molyneaux PL, Lukey PT, Marshall RP, Renzoni EA, et al. Daily Home Spirometry: An Effective Tool for Detecting Progression in Idiopathic Pulmonary Fibrosis. Am J Respir Crit Care Med. 2016;194(8):989-97
[2] Khan F, Howard L, Hearson G, Edwards C, Barber C, Jones S, et al. Clinical Utility of Home versus Hospital Spirometry in Fibrotic Interstitial Lung Disease: Evaluation after INJUSTIS Interim Analysis. Ann Am Thorac Soc. 2022;19(3):506-9.
Acknowledgements: The authors would like to extend their gratitude to all the patients who took part in this study; the research and ILD specialist nurses and pulmonary function test technicians and patientMpower. WL Ng was funded by a two-year Strategic Academic Research Doctor in Medicine (StAR MD) Programme by the Royal College of Surgeons in Ireland in collaboration with Beacon Hospital to carry out this study. WL Ng has also received additional funding from the Irish Society for Rheumatology’s Rheumatology Patient Initiative Fund. KH was supported by the Health Research Board, Ireland, Emerging Clinical Scientist Award (ECSA-2020-011).
Disclosure of Interests: None declared.
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