WS05.6 A pilot study of enhanced community support via internet videoconferencing and physiotherapist home visits

Abstract

Objectives Specialist centre care only is recommended for all UK Adult CF patients. Many patients face long journeys to attend the centre. This may lead to poor attendance and engagement. We evaluated the feasibility and effect of regular patient contact at home via videoconferencing and home visits from CF physios in selected patients with a history of poor engagement with and long journey time to the centre. Methods 20 patients were invited to take part. Study patients were supplied with a laptop and webcam and Cisco Movi secure videoconferencing software. Weekly contact via video and monthly home visits were planned for 6 months. Outcomes were assessed by a patient satisfaction survey and regular FEV1, CFQ-R scores and weight. Results 6 patients agreed to take part and 5 completed follow up. Videoconferencing was frequently unsuccessful due to poor rural broadband speeds, ICT support and patient engagement. Patients satisfaction was high for both videoconferencing and home visits with perception of improved health and treatment concordance. Home visits were felt to be of greatest benefit. 2 patients saw significant improvements in FEV1 and weight. Staff perception of concordance improved in 3 patients. CFQ-R scores did not show consistent trends in any domain. Conclusion Uptake of free enhanced home support was low in patients with a history of poor engagement, living in remote locations and is not a panacea for this problem. Rural broadband speeds are often inadequate to support videoconferencing. In selected patients internet video support and home visits can successfully augment usual care with objective and subjective benefits and is rated highly by patients.