New patientMpower Data at BTS Winter Meeting 2022
- patientMpower-enabled home spirometry is accurate and useful in 80% of consultations for lung transplant follow-up care, based on an a service evaluation at Manchester’s Lung Transplant Unit
- Results from a multi-centre study show patientMpower-enabled daily recording of home spirometry and pulse oximetry within an ILD clinical service setting is highly feasible, with patient adherence ≥ 89%
- Secondary analysis suggests patient adherence to home spirometry may be higher in those with more advanced disease
Three years have passed since the last face-to-face BTS conference, so it was great to be back among friends and partners for the BTS Winter Meeting last week. There was plenty of new patientMpower data presented at the BTS meeting this year too, with three posters in total; one in lung transplant and two in ILD.
Bobby Hiu Nam Chow and the team from Manchester’s Lung Transplant Unit presented an evaluation of the patientMpower-enabled home spirometry programme which has been running at the centre since 2020. This review provides further evidence of the accuracy, acceptability and utility of the patientMpower platform for follow-up of patients after lung transplant, very much in line with experience from NYU Lagone and the Mater Hospital transplant centres.
In ILD, Sarah Barth from Imperial College Healthcare NHS Trust presented two posters based on results from the multicenter trial NCT04850521. Top line results from the trial were initially presented at ERS earlier this year, but data released at BTS further demonstrates the feasibility of daily recording of home spirometry and pulse oximetry within an ILD clinical service setting. And whilst patient adherence to home spirometry was high across the whole study cohort (at 89%), secondary analysis suggests those with more advanced disease may be more engaged with home spirometry. This data addresses any potential concerns regarding the ability and willingness of those with more severe disease to perform home spirometry.
Summaries and links to each of the poster presentations are provided below, or for any additional information do not hesitate to get in touch at info@patientMpower.com
An Evaluation of Home Spirometry following Lung Transplantation
The patientMpower-enabled home spirometry monitoring programme at the Transplant Unit at Wythenshawe Hospital, Manchester was established initially in response to the restrictions and risks posed by the COVID-19 pandemic, and had enrolled 164 lung transplant patients at the time of this review. The programme evaluation encompassed comparison of home versus recent clinic spirometry results, along with feedback from clinicians and patients obtained through questionnaires.
The evaluation found the home spirometry programme provided accurate results, which was useful in the clinical setting and is acceptable to patients. In addition, it provided real time remote monitoring aiding in assessment of allograft function, which was a benefit over the analogue spirometer which had been used previously.
Key results
Accuracy:
- FEV1 and FVC home and clinic spirometry values were well correlated
- The R2 was 0.69 and 0.59 for FEV1 and FVC respectively (p<0.01)
Clinician Feedback:
- Home spirometry was useful in 79.6% (n=112) of consultations
- The need for hospital spirometry was removed in 63% of cases
Adherence:
- 50% of patients submitted readings at least three times per week.
Patient feedback:
- The median patient rating of the programme was 9 out of 10.
- 91.4% of patients reported spirometer was easy to use
- 86% reported the spirometer was compact
- 71% reported the app was helpful
- 88.4% preferred the Bluetooth spirometer vs analog device
Study NCT04850521 was a prospective, single-arm, observational study recruiting patients across four UK centres. The aim was to assess the feasibility of the introduction of remote monitoring into ILD clinical service. Patients with MDT-confirmed ILD diagnosis were asked to record 1 spirometry & pulse oximetry measurement per day for 91 days, using the patientMpower application & Bluetooth-linked devices. The co-primary endpoints were estimation of patients providing measurements on 70% study days and 3 times/every week during the study. 60 patients provided 1 spirometry reading and were included in analysis:
- Median adherence was 89.0% to remote spirometry and 92.3% to pulse oximetry
- 78% of patients maintained adherence to spirometry on 70% of study days
- 82% maintained adherence to pulse oximetry on 70% of study days
- 70% recorded spirometry 3 times/ week every week
- 72% recorded pulse oximetry 3 times/ week every week
- 78% spirometry at least once a week
- 80% recorded pulse oximetry at least once a week
Digital home monitoring of spirometry and pulse oximetry in patients with ILD is highly feasible. Given the high sensitivity of frequent spirometry in predicting disease progression in ILD, home spirometry is a realistic and highly valuable alternative to hospital-based assessment.
What affects acceptability of remote digital monitoring of spirometry in ILD patients?
This was a secondary analysis of study NCT04850521, a multi-centre UK study which examined the use of patientMpower-enabled recording of daily home spirometry and pulse oximetry in patients with ILD for a 91 day study period. The aim of the analysis was to examine factors which may determine patient adherence to home monitoring.
Sixty patients were included in the analysis of adherence:
- Adherence to daily recording of home spirometry in the total cohort was high, at 89%.
- There were weak correlations between adherence and disease severity, and adherence and patient age
- There was no significant correlation between adherence and baseline HRQoL, or change in HRQoL, or in ILD subtype diagnosis.
Of the 53% of patients who responded to the experience survey:- All stated home spirometry was easy to perform and felt that it was useful.
- Majority (74%) wished to continue to monitor their spirometry.
The data shows home spirometry is acceptable and useful to patients with ILD, and those with more severe disease may be even more engaged with home monitoring.