IMPACT OF MAIL-IN SPUTUM CULTURES IN DELIVERY OF CYSTIC FIBROSIS CARE VIA TELEHEALTH

Abstract

TOPIC: Education, Research, and Quality Improvement TYPE: Original Investigations PURPOSE: Cystic fibrosis (CF) is a multi-organ disease due to a mutation in the cystic fibrosis transmembrane conductance regulator gene. The mutation causes viscous mucus to accumulate in vital organs including the lungs. The thick mucus layers serve as sites of infection which are a significant cause of morbidity and mortality in CF patients. Sputum samples assess the types of pathogens that colonize CF patients’ lungs and can be used to guide treatment. Prior to the COVID-19 pandemic, sputum cultures were almost exclusively collected in the clinical setting. The purpose of this study was to examine the effectiveness of at-home collection of sputum samples. Specifically, we aimed to see if mail-in sputum samples can replace samples collected in clinic, thereby increasing accessibility of remote CF care. METHODS: Adult and pediatric patients were provided a mail-in sputum kit from the clinic along with instructions on collecting and shipping samples. Kits were completed by 7 adult and 32 pediatric patients from March 2020 to April 2021. The samples were shipped via FedEx to the microbiology lab for processing. The results were then compared with those of the patients’ previous hospital cultures from 2017-2020 for pediatrics and 2019-2020 for adults for reliability. The mail-in cultures were considered reliable if the patients’ previous in-clinic sputum samples had grown at least 50% of the same pathogens grown from the mail-in sample. RESULTS: Mail-in samples were reliable for 85.7% of the adult patients and 92.9% of the pediatric patients. Four pediatric patients were excluded from the study because they had not completed an in-hospital sputum sample. CONCLUSIONS: Given that the pathogens between adult and pediatric cultures were reliable 85.7% and 92.9% of the time respectively, mail-in sputum cultures appear to be an effective form of remote maintenance care in CF patients. Implementing mail-in culture protocols can expand the efficacy of telehealth in routine CF patient care. CLINICAL IMPLICATIONS: Future studies should look at optimizing patient education on mail-in sputum collection to facilitate ease of access. The usage of mail-in cultures can minimize the need for CF patients to come into the hospital for testing and in-clinic visits. DISCLOSURES: No relevant relationships by Madihah Alam, source=Web Response No relevant relationships by Sarah Barrett, source=Web Response Advisory Committee Member relationship with PARI Please note: 2019 Added 04/14/2021 by Nauman Chaudary, source=Web Response, value=Honoraria Moderator relationship with PARI Please note: 2021 Added 04/14/2021 by Nauman Chaudary, source=Web Response, value=Consulting fee Advisory Committee Member relationship with DYMEDSO Please note: 2021 Added 04/14/2021 by Nauman Chaudary, source=Web Response, value=Consulting fee No relevant relationships by Karen Lo, source=Web Response