Abstract
Home spirometry after lung transplantation is common practice, to monitor graft function. However, there is little experience with online home monitoring applications with direct data transfer to the hospital. We evaluated the feasibility and patient experiences with a new online home monitoring application, integrated with a Bluetooth-enabled spirometer and real-time data transfer. Consecutive lung transplant recipients were asked to evaluate this home monitoring application for three months in a pilot study. Home spirometry measurements were compared with in-hospital lung function tests (the forced expiratory volume in 1 s (FEV1) and forced vital capacity (FVC)) at the end of the study. Ten patients participated. The home and hospital spirometry measurements showed a high correlation, for both the FEV1 (r = 0.99, p < 0.01) and FVC (r = 0.99, p < 0.01). The adherence and patient satisfaction were high, and the patients preferred the home monitoring application over the current home spirometer, with a difference of 1.4 ± 1.5 points on a scale from 0 to 10 (p = 0.02). Online home monitoring with direct data transfer is feasible and reliable after lung transplantation and results in high patient satisfaction. Whether the implementation of online home monitoring enables the earlier detection of lung function decline and improves patient and graft outcomes will be the subject of future research.
Highlights
Lung transplantation is a lifesaving treatment option in selected patients with end-stage lung disease
We aimed to evaluate the feasibility, reliability, and patient experiences with a new online home monitoring application, integrated with a Bluetooth-enabled spirometer and real-time transfer of data
We evaluated the within-subject reproducibility of the forced expiratory volume in 1 s (FEV1) and forced vital capacity (FVC) and adherence to home spirometry
Summary
Lung transplantation is a lifesaving treatment option in selected patients with end-stage lung disease. Patients are instructed to contact the transplant team if their lung function declines or symptoms arise in between clinic visits; there is no direct data transfer and feedback on changes in lung function and the quality of the measurements outside the hospital, and the monitoring of adherence is not possible. This leads to variability in adherence and responses to changes, and may cause uncertainty in a subgroup of patients in when to contact the hospital. It could be hypothesized that direct data transfer to the lung transplantation center can lead to the earlier detection of non-adherence or a decline in lung function, facilitate personalized treatment, and reduce anxiety in patients
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