Home spirometry and virtual visits in children with cystic fibrosis – the child’s perspective

ABSTRACT

Objectives: Children with cystic fibrosis (CF) in Sweden are routinely monitored at the hospital more often than the recommended CF guidelines. The COVID-19 pandemic has challenged the healthcare system and the use of digital tools and virtual visits has rapidly increased. The aim of this study was to investigate how children experienced home spirometry (HS) and virtual visits. Methods: A prospective multicentre study including children aged 5–17 years from all 4 Swedish CF centres were conducted between May 2020 to November 2021. All participants received a home spirometer AirNext (NuvoAir,Stockholm, Sweden). Physical visits could be converted to virtual visits during the study and the children were instructed to perform HS prior to both virtual and a physical visits. An anonymous survey was conducted at the end of the study. Results: A total of 60 children with CF were included in the study. During the mean (range) study period of 6.8 (3.1–11.5) months, they completed on average 2.3 (1–4) virtual visits and 3.0 (2–4) physical visits. The survey was completed by 55 (92%) participating children with a mean age of 11.5 (5– 17) years. The virtual visitswere rated just as high as the physical meetings. No child felt more stressed with the opportunity to perform HS;on the contrary, some children (22%) felt less stressed with this possibility. After the introduction of HS, almost all children (98%) responded that they felt calmer or as before the introduction of HS. Half of the children responded that they nowunderstand their CF-disease better than before. Virtual visits reduced the burden of travel time to the hospital and shortened the mean time away from school up to 3.0 (1.3–4.0) days over a year. Conclusion: Home spirometry increased the understanding of the CF lung disease and did not cause more stress in children with CF. Virtual visits were very appreciated and provide a possibility to decrease school absenteeism due to fewer physical visits at the hospital.