P34 Feasibility of remote monitoring with daily home spirometry and pulse oximetry in an interstitial lung disease clinical service setting

Abstract

<h3>Introduction</h3> Remote monitoring of patient-recorded spirometry &amp; pulse oximetry offers an alternative approach to traditional hospital-based monitoring of interstitial lung disease (ILD), which may support resource optimisation and patient safety. Whilst studies have shown agreement between remote and hospital based spirometry, remote monitoring has not been widely incorporated into clinical practice. We aimed to assess the feasibility of the introduction of remote monitoring into the clinical service. <h3>Methods</h3> Prospective, single-arm, observational study recruited across four UK centres (NCT04850521). Criteria included MDT-confirmed ILD diagnosis and ppFVC&gt;50%. Patients were asked to record 1 spirometry &amp; pulse oximetry measurement per day for 91 days, using a digital health application &amp; Bluetooth-linked devices, monitored weekly by their clinicians. Feasibility of remote monitoring was defined as ≥41 patients with ≥70% adherence to study measurements throughout the observation period. Adherence was calculated as days with measurements/91 days. The co-primary endpoints were estimation of patients providing measurements on ≥ 70% study days and ≥ 3 times/every week during the study. <h3>Results</h3> 62 patients consented and 60/62 provided ≥1 spirometry reading and were included in analysis: 42/60 male; age 67.8 years (± 11.2); 33/60 (55%) idiopathic pulmonary fibrosis (IPF), 27/60 (45%) had non-IPF ILD; clinical ppFVC 84.3%(±19.8); clinical ppDL_CO53.85% (±18.2); Median modified ILD-GAP score was 3 (IQR 1–4.75). There was one adverse event of a patient who experienced a vasovagal episode during spirometry. 47 patients (78%) maintained adherence to spirometry and 49 patients (82%) maintained adherence to pulse oximetry on ≥70% of study days. 42 patients (70%) recorded spirometry and 43 patients (72%) recorded pulse oximetry ≥3 times/week every week during the study. This increased to 78% and 80% respectively, for recordings at least once a week during the study. Median adherence was 89.0% (IQR 72.2–95.6%) to remote „spirometry and 92.3% (IQR 74.5–96.7%) to pulse oximetry. <h3>Conclusion</h3> This study demonstrates feasibility of daily recording of home spirometry &amp; pulse oximetry within a clinical service over 3 months. Further analysis is required to understand the impact of introduction of remote monitoring into the clinical service. Supported by Innovate UK (ref 66823) Please refer to page A213 for declarations of interest related to this abstract.