EPS1.05 Evaluating impacts of the change from clinic to home spirometry on clinicians and adults with cystic fibrosis

Abstract

Background: During the COVID-19 pandemic, people with cystic fibrosis (pwCF) were considered clinically vulnerable & asked to shield. A national scheme supported purchase of spirometers enabling pwCF to do home spirometry to support virtual clinics. PwCFattending the York Hull adult CF centre (YHACFC) were provided with NuvoAir spirometers. Objectives: To evaluate how the change from clinic to home spirometry impacted on the experiences of pwCF & clinicians, focusing on anxiety levels & use of time. Methods: Online questionnaires were sent to pwCF & clinicians at YHACFC. Mock scenarios established potential differences in time taken for home spirometry (HS) & clinic spirometry (CS). Results: 28/70 pwCF & 8/15 clinicians responded. PwCF & clinicians were confident that pwCF could use HS. Frequently used words for both groups were “quick,” “convenient” & “easy” when describing HS. When describing CS, “expertise” & “helpful” featured for pwCF and “time”, “stressful” & “accurate” for clinicians. PwCF reported the main benefit of CS was regular contact with clinicians. 62.5% of clinicians agreed that the change to HS gave better time efficiency & 87.5% agreed clinic flow was more efficient with HS. Timed scenarios indicated 7½ minutes per test saved with HS. Most clinicians believed pwCF are anxious with spirometry, 50% linking anxiety to the clinic setting. Most pwCF reported never being anxious about HS or CS. Only 4% reported anxiety with CS;however, when describing CS, the words “anxious” & “worry” were used frequently. The preference for 82% of pwCF for future care was access to a combination of spirometry in the home & clinic. Conclusion: • Home spirometry saved time for pwCF & clinicians. • Virtual technology has an important & developing role in the care of pwCF but relationships remain valued. • Style of questioning affects response from pwCF about spirometry anxiety. • Disparity between pwCF reported anxiety & clinicians’ perceptions of anxiety needs further investigation.