P070 Rheum to Empower: Home Spirometry and Oximetry Monitoring in Connective Tissue Related Interstitial Lung Disease

Abstract

Abstract Background/Aims Interstitial lung disease (ILD) is a common cause of morbidity and mortality in connective tissue diseases (CTDs). Distinct challenges arise for individuals with impairments from rheumatic diseases, especially when coupled with respiratory symptoms. While home spirometry monitoring is valuable for patients with idiopathic pulmonary fibrosis (IPF), its applicability in CTD related ILD (CTD-ILD) is relatively unexplored. This study examines the feasibility and acceptability of home spirometry and oximetry monitoring in CTD-ILD patients compared with those with IPF. Methods Patients with CTD-ILD and IPF were recruited prospectively in a tertiary hospital. A portable handheld spirometer (MIR Spirobank Smart) and a Nonin finger oximeter linked to a smartphone app were provided, and patients were educated on its use. Spirometry and oximetry results were collated. At six months, a survey was conducted to assess patients’ perception of home monitoring. Results Fourty-one patients with CTD-ILD and 51 with IPF were recruited. The median ages were 66 and 71 years respectively (Table 1). 2946 FVC and 2787 oximetry readings were captured in the CTD-ILD cohort compared with 4984 FVC and 4778 oximetry readings in the IPF cohort. Among the 41 patients, 12 experienced Raynaud’s phenomenon. Only 7.32% (3/41) of CTD-ILD patients required an ear oximeter due to inaccurate oxygen saturation measurement caused by Raynaud’s phenomenon. Among the CTD-ILD cohort, 16.67% (6/36) experienced difficulty using the devices due to hand problems, while none of the IPF cohort encountered such issues. In the survey, patients reported barriers to long-term remote monitoring usage included forgetting to use, coughing or breathlessness. Less than one-third of patients indicated that spirometry and oximetry results contributed to health anxiety. A majority of patients found home monitoring useful and insightful, and would recommend this to others. Conclusion Our findings suggest the practicality of remotely monitoring FVC and oximetry in CTD-ILD patients, even with challenges like Raynaud’s phenomenon and impaired hand function. This not only underscores feasibility but also empowers patients through continuous monitoring despite physical limitations. Incorporating remote monitoring into standard care should be regarded as an essential approach for this understudied population, enhancing both clinical management and patient empowerment. Disclosure W. Ng: Grants/research support; StAR MD Scholarship, ISR Rheumatology Patient Initiative Fund. D. Howard: None. L. Durcan: None. K. Hurley: Grants/research support; Health Research Board, Ireland, Emerging Clinical Scientist Award (ECSA-2020-011).