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@article{Maher:2022:10.1186/s12931-022-02221-4,
author = {Maher, TM and Schiffman, C and Kreuter, M and Moor, CC and Nathan, SD and Axmann, J and Belloni, P and Bengus, M and Gilberg, F and Kirchgaessler, K-U and Wijsenbeek, MS},
doi = {10.1186/s12931-022-02221-4},
journal = {Respiratory Research},
title = {A review of the challenges, learnings and future directions of home handheld spirometry in interstitial lung disease},
url = {http://dx.doi.org/10.1186/s12931-022-02221-4},
volume = {23},
year = {2022}
}

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TY  - JOUR
AB  - BackgroundPatients with interstitial lung disease (ILD) require regular physician visits and referral to specialist ILD clinics. Difficulties or delays in accessing care can limit opportunities to monitor disease trajectory and response to treatment, and the COVID-19 pandemic has added to these challenges. Therefore, home monitoring technologies, such as home handheld spirometry, have gained increased attention as they may help to improve access to care for patients with ILD. However, while several studies have shown that home handheld spirometry in ILD is acceptable for most patients, data from clinical trials are not sufficiently robust to support its use as a primary endpoint. This review discusses the challenges that were encountered with handheld spirometry across three recent ILD studies, which included home spirometry as a primary endpoint, and highlights where further optimisation and research into home handheld spirometry in ILD is required.Abstract bodyRate of decline in forced vital capacity (FVC) as measured by daily home handheld spirometry versus site spirometry was of primary interest in three recently completed studies: STARLINER (NCT03261037), STARMAP and a Phase II study of pirfenidone in progressive fibrosing unclassifiable ILD (NCT03099187). Unanticipated practical and technical issues led to problems with estimating FVC decline. In all three studies, cross-sectional correlations for home handheld versus site spirometry were strong/moderate at baseline and later timepoints, but longitudinal correlations were weak. Other issues observed with the home handheld spirometry data included: high within-patient variability in home handheld FVC measurements; implausible longitudinal patterns in the home handheld spirometry data that were not reflected in site spirometry; and extreme estimated rates of FVC change.ConclusionsHome handheld spirometry in ILD requires further optimisation and research to ensure accurate and reliable FVC measurements before it
AU  - Maher,TM
AU  - Schiffman,C
AU  - Kreuter,M
AU  - Moor,CC
AU  - Nathan,SD
AU  - Axmann,J
AU  - Belloni,P
AU  - Bengus,M
AU  - Gilberg,F
AU  - Kirchgaessler,K-U
AU  - Wijsenbeek,MS
DO  - 10.1186/s12931-022-02221-4
PY  - 2022///
SN  - 1465-9921
TI  - A review of the challenges, learnings and future directions of home handheld spirometry in interstitial lung disease
T2  - Respiratory Research
UR  - http://dx.doi.org/10.1186/s12931-022-02221-4
UR  - https://www.webofscience.com/api/gateway?GWVersion=2&SrcApp=PARTNER_APP&SrcAuth=LinksAMR&KeyUT=WOS:000881987700002&DestLinkType=FullRecord&DestApp=ALL_WOS&UsrCustomerID=1ba7043ffcc86c417c072aa74d649202
UR  - http://hdl.handle.net/10044/1/100844
VL  - 23
ER  -

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