Electronic home monitoring of children with cystic fibrosis to detect and treat acute pulmonary exacerbations and its effect on 1-year FEV1


Yanaz M., Yilmaz Yegit C., Gulieva A., Kalyoncu M., UZMANOĞLU M. S., Uzunoglu B., ...Daha Fazla

Journal of Cystic Fibrosis, 2023 (SCI-Expanded) identifier identifier

  • Yayın Türü: Makale / Tam Makale
  • Basım Tarihi: 2023
  • Doi Numarası: 10.1016/j.jcf.2023.09.007
  • Dergi Adı: Journal of Cystic Fibrosis
  • Derginin Tarandığı İndeksler: Science Citation Index Expanded (SCI-EXPANDED), Scopus, Academic Search Premier, MEDLINE
  • Anahtar Kelimeler: Cystic fibrosis, Forced expiratory volume in 1 second, Home spirometry, Pulmonary exacerbations
  • Marmara Üniversitesi Adresli: Evet

Özet

Background: We aimed to investigate the effect of the use of electronic home spirometry in children with cystic fibrosis (CF) on 1-year FEV1 (% predicted, pp) change. Methods: This is a randomised, one-year prospective study including children with CF between 6 and 18 years of age. Subjects were randomised into home spirometry group (HSG) and usual care group (UCG). Children in HSG performed two pulmonary function tests (PFT) per week. Data regarding acute pulmonary exacerbations (PEx) was obtained from patients’ records. At baseline and 12th month, health related quality of life questionnaire for CF patients (CFQ-R) and lung clearance index (LCI) were performed. Results: Sixty children were recruited with a median (IQR) age of 13.3 (11.4–15.4) years. Absolute change in FEV1pp from baseline to 12th month as median (IQR) was +1% (-6.75–9.75) in HSG and -2.50% (-7.50–3.25) in UCG (p = 0.10). Sensitivity analysis including only adherent children in HSG (n = 22), yielded an increase of 5% (-3.50–12) in HSG and a decrease of 2.50% (-7.50–3.25) in UCG (p = 0.009). A total of 29 (96.7%) subjects in HSG and 23 (76.7%) in UCG had PEx (p = 0.05). Absolute change in median (IQR) LCI2.5 from baseline to the 12th month was -1.6 [-2.9–0] (p<0.001) in HSG and -1.5 [-2.8-(-0.6)] (p<0.001) in UCG (p = 0.94). There was a significant increase in the social domain of the CFQ-R in HSG (from 59.1 to 76.2, p = 0.01). Conclusions: Electronic home monitoring of children with CF by spirometry may result in improvement in lung function.