The Feasibility and Validity of Home Spirometry for People with Cystic Fibrosis: Is It Comparable to Spirometry in the Clinic?

Background/

Objectives

Home spirometry allows people with cystic fibrosis (CF) to monitor their lung function from home. However, there are concerns about its feasibility and validity compared to traditional clinic spirometry. The aim of this study was to evaluate the feasibility and validity of telehealth spirometry for patients with CF living in a regional setting.

Methods

This retrospective study included forty-eight people with cystic fibrosis (pwCF) aged 6-33 years. Participants performed home spirometry using a portable flow sensor spirometer over a one-year period, without supervision. Spirometry readings from portable spirometers were compared with the nearest in-clinic spirometry using the intra-correlation coefficient (ICC) and Bland-Altman plots. Data were collected over a period of one year, with regular intervals of measurements.

Results

In 427 of the 877 (48.6%) attempted sessions, successful spirometry at home was recorded. Although we showed good reliability between at-home and in-clinic measurements using the Bland-Altman plots and intraclass correlation co-efficient (ICC) (values ranged from 0.76 to 0.88), analysis of the 117 pairs of at-home and in-clinic spirometries showed that mean differences of forced expiratory volume in the 1st sec (FEV1) and forced vital capacity (FVC) obtained at home (both in liter and z-score) had, on average, lower values than the corresponding values at the clinic.

Conclusions

Home-based telehealth spirometry is feasible among pwCF and provides advantages, especially for those from remote or secluded areas. However, lower values in FVC and FEV1 obtained through home spirometry should not be used interchangeably with clinic values.