The clinical effectiveness and validity of home spirometry in children with cystic fibrosis

Introduction: During the COVID-19 pandemic, home spirometry became essential for continued monitoring of cystic fibrosis patients, however, the clinical effectiveness was unknown. Aim(s): The aims of this study were to assess the success rate of testing patients at home and to compare the home spirometry and lab spirometry results Methods: 147 home spirometry devices (Air Next, NuvoAir, USA) were given out to cystic fibrosis patients (M:F 67:80;mean age 11.8 [4.7 - 17.3]) who had previous experience of spirometry and deemed to be competent to perform spirometry at home. Patients were asked to perform 4 tests in the first month, then 1 test per month unless clinically requested. When Lab spirometry resumed, 28 (M:F 12:16;mean age 13.1 [8.0-17.0]) patients tested on NuvoAir within 5 days (mean 0.7 days (1.0)) of Lab spirometry (Vyntus Spiro, Vyaire Medical, USA). Correlation between spirometry indices were analysed using linear regression. Result(s): 142 patients (96.6%) successfully onboarded onto the NuvoAir platform. Between July 2020 and Jan 2022, 1854 tests were performed, with 1711 (92.3%) tests over-read to be valid. 54 patients (36.7%) performed >=15 tests requested. FEV1 (R2 = 0.93, p = <0.00), FVC (R2 = 0.91, p = <0.00), MMEF (R2 = 0.87, p = <0.00) and PEF (R2 = 0.88, p = <0.00) all showed significant correlation between Lab spirometry and Home spirometry. Conclusion(s): Our results show that home spirometry is well adopted by cystic fibrosis patients and they are able to perform valid loops on this device. Continual encouragement may be required to achieve good trend data. There is also close agreements between this home spirometry device and the gold standard of laboratory spirometry.

Moving into year 7: A pilot study to assess to the usefulness of an on-line group session to prepare young people with cystic fibrosis for transitioning to secondary school

IntroductionStarting secondary school is a big step for any child and their family but particularly so if they have a chronic condition such as cystic fibrosis (CF). Hospital teams can assist with the preparation required for the transition. CF is different from other chronic conditions with respect to holding transition events, as face to face events are not possible due to the risk of cross-infection of different organisms between patients. In order to overcome this, the CF team at Alder Hey Children’s Hospital created a virtual event named ‘MI7’ (Moving Into year 7).MethodEvents were held via video conferencing software and questionnaires sent to all participants before the event and afterwards. All patients in year 6 cared for by the Alder Hey CF network were invited to participate with a maximum of 7 young people per group. Packs were sent out beforehand. Sessions consisted of ice-breaker games and CF team led discissions.ResultsA pilot event was held in 2019. This was well-received and follow-up from the families was sought after the first term at secondary school. Unfortunately, due to the COVID pandemic, the event could not be held in 2020, but it went ahead in 2021 and 2022.There was a distinct difference between the event held in 2019 and 2021/22, in that everyone (the hospital team members, and the patients and their families) was much more familiar with participating in a virtual event, due to the way this practice had become commonplace during the COVID pandemic.Overall 22 people have participated in these events to date. 25% described being worried about going to secondary school. All young people gave at least one thing that they were worried about and the most common finding was getting lost (21%). The most common CF related worry was regarding taking creon and 12% cited this as a concern. Less than 25% of all concerns given related to CF with the remainder being more generic concerns.All participants stated that they enjoyed the event and most found it useful.ConclusionTransition events to help this patient population move from primary to secondary school are feasible, enjoyable for young people with CF and useful.

The Clinical Effectiveness and Validity of Home Spirometry in Children with Cystic Fibrosis

Aims During the COVID-19 pandemic, home spirometry became essential for continued monitoring of cystic fibrosis patients, however, the clinical effectiveness was unknown.The aims of this study were to assess the success rate of testing patients at home and to compare the results to the gold standard testing (in lab spirometry). Methods 147 home spirometry devices (Air Next, NuvoAir, USA) were given out to cystic fibrosis patients (M:F 67:80;mean age 11.8 [4.7 - 17.3]) who had previous experience of spirometry and deemed to be competent to perform spirometry at home. Patients were asked to perform 4 tests in the first month, then 1 test per month unless clinically requested. When Lab spirometry resumed, 28 (M:F 12:16;mean age 13.1 [8.0-17.0]) patients tested on NuvoAir within 5 days (mean 0.7 days (1.0)) of Lab spirometry (Vyntus Spiro, Vyaire Medical, USA). Correlation between spirometry indices were analysed using linear regression. Results 142 patients (96.6%) successfully onboarded onto the NuvoAir platform. Between July 2020 and Jan 2022, 1854 tests were performed, with 1711 (92.3%) tests over-read to be valid. 54 patients (36.7%) performed >=15 tests requested. FEV1 (R2 = 0.93, p = <0.00), Ratio (R2 = 0.70, p = <0.00), FVC (R2 = 0.91, p = <0.00), MMEF (R2 = 0.87, p = <0.00) and PEF (R2 = 0.88, p = <0.00) all showed significant correlation between Lab spirometry and Home spirometry. Conclusion Our results show that home spirometry is well adopted by cystic fibrosis patients, however, continual encouragement may be required. We have also shown that valid spirometry loops can be performed by cystic fibrosis patients on this device. There is also close agreement between this home spirometry device and the gold standard of lab spirometry and therefore, results can be deemed valid and reliable.