ERJ open research · 2026
Healthcare professionals' perspectives on implementation of home monitoring in individuals with pulmonary fibrosis.
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Hofman Delian E, Moor Catharina C, Mostard Rémy L M, van Beek Frouke T, Gür Yasmin, Ooijevaar Jolande, Wijsenbeek Marlies S, de Mul Marleen
Аннотация
INTRODUCTION: Home monitoring of physical parameters, symptoms and quality of life in individuals with pulmonary fibrosis (PF) could overcome gaps in clinical care by enabling early detection of disease progression, guiding patient management and improving access to specialised care. However, its global adoption in clinical practice is lacking. The aim of this study is to gain a deeper understanding of healthcare professionals' (HCPs) perspectives on implementing home monitoring for individuals with PF.
METHODS: Semi-structured interviews were conducted with HCPs. Transcripts were analysed through an inductive-deductive qualitative thematic analysis using the NASSS (nonadoption, abandonment, scale-up, spread and sustainability) framework, which provides a systematic method for examining barriers and facilitators that may hamper the implementation of technological innovations.
RESULTS: 30 HCPs from 18 interstitial lung disease clinics in the Netherlands were interviewed, reflecting varying levels of experience with home monitoring. They were positive towards the implementation of home monitoring for individuals with PF, favouring a tailored hybrid care approach. HCPs preferred incorporating home spirometry and alerts for signs of deterioration. Different barriers were identified to implement home monitoring and hybrid care pathways, including technical challenges, such as reduced reliability of home spirometry in certain patients and concerns about replacing care for progressive or unstable patients. HCPs emphasised the need for a coordinated hybrid care pathway and they advocated for strong evidence on cost-effectiveness and quality of hybrid care models.
DISCUSSION: Home monitoring is considered valuable in the management of PF. Identified preferences, barriers and facilitators can be used to inform strategies for sustainable implementation of home monitoring in clinical practice.
METHODS: Semi-structured interviews were conducted with HCPs. Transcripts were analysed through an inductive-deductive qualitative thematic analysis using the NASSS (nonadoption, abandonment, scale-up, spread and sustainability) framework, which provides a systematic method for examining barriers and facilitators that may hamper the implementation of technological innovations.
RESULTS: 30 HCPs from 18 interstitial lung disease clinics in the Netherlands were interviewed, reflecting varying levels of experience with home monitoring. They were positive towards the implementation of home monitoring for individuals with PF, favouring a tailored hybrid care approach. HCPs preferred incorporating home spirometry and alerts for signs of deterioration. Different barriers were identified to implement home monitoring and hybrid care pathways, including technical challenges, such as reduced reliability of home spirometry in certain patients and concerns about replacing care for progressive or unstable patients. HCPs emphasised the need for a coordinated hybrid care pathway and they advocated for strong evidence on cost-effectiveness and quality of hybrid care models.
DISCUSSION: Home monitoring is considered valuable in the management of PF. Identified preferences, barriers and facilitators can be used to inform strategies for sustainable implementation of home monitoring in clinical practice.