Long-term clinical impact of a virtual model of care in cystic fibrosis

ABSTRACT

Background: Health professionals have explored and tested the use of digital technologies provide in managing chronic respiratory diseases remotely during the COVID-19 pandemic. Further investigation into whether these new approaches to care delivery provide an opportunity to improve cystic fibrosis (CF) management is needed. The aim of this study was to assess the long-term clinical impact of use of e-health as part of a virtual model of care in CF. Method(s) The NuvoAir Home platform consists of a smartphone application, Bluetooth spirometer, and clinician portal. Patients were trained to use the platform and asked to perform home spirometry monthly. Data on pulmonary function and pulmonary exacerbations were collected at baseline and after 12 months. A surveywas emailed to evaluate patients' experience using the technology. Result(s) A cohort of 43 people with CFwere recruited (26 female;mean age 31.6 +/- 6.8;16 homozygous for delta F508;FEV1 48.4 +/- 16.3% predicted). Sustained improvement in forced expiratory volume in 1 second (FEV1) expressed as absolute and percentage predicted was seen through 12 months (mean absolute change 100 mL, p = 0.02;mean percentage predicted change 3.8%, p = 0.005). We found significant improvement in forced vital capacity expressed as absolute value (mean change 230 mL, p = 0.006) and percentage predicted (mean change 6.2%, p = 0.002). The average of number of exacerbations per person 1 year before use of digital technology was 0.84, vs 0.09 1 year after ( p < 0.001). Ninety percent of patients reported that they understood their CF better after starting the virtual care service. No changes in medical treatmentwere reported during that time. Conclusion(s) Use of digital technologies in the management of adults with CF improved lung function and decreased pulmonary exacerbations. People with CF readily accepted using a virtual model of care and improved their understanding of their medical condition. Copyright © 2022, European Cystic Fibrosis Society. All rights reserved