作为间质性肺病临床护理的一部分,远程监测肺活量和脉搏血氧仪的可行性和可接受性:单臂观察研究

IF 4.7 2区 医学 Q1 RESPIRATORY SYSTEM Respiratory Research Pub Date : 2024-04-15 DOI:10.1186/s12931-024-02787-1
Sarah Barth, Colin Edwards, Gauri Saini, Yussef Haider, Nicholas Paul Williams, Will Storrar, Gisli Jenkins, Iain Stewart, Melissa Wickremasinghe
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引用次数: 0

摘要

对患者记录的肺活量和脉搏血氧饱和度进行远程监测为传统的医院间质性肺病(ILD)监测提供了一种替代方法。据观察,远程肺活量能合理反映 ILD 患者的门诊肺活量,但远程监测尚未广泛应用于临床实践。我们评估了在 ILD 临床服务中对患者进行远程监测的可行性。前瞻性、单臂、开放标签多中心观察研究(NCT04850521)。纳入标准包括:ILD 诊断、年龄≥ 18 岁、FVC 预测值≥ 50%。要求 60 名参与者每天至少记录一次肺活量和血氧饱和度测量,每周由当地临床团队进行监测。可行性的定义是:≥ 68% 的参与者对研究测量的坚持率≥ 70%,且在整个过程中记录测量次数≥ 3 次/周。共有 60 名参与者参与分析。42/60(70%)为男性;平均年龄为 67.8 岁(± 11.2);34/60(56.7%)患有特发性肺纤维化(IPF),ILD-GAP 评分中位数为 3(IQR 1-4.75)。46/60名参与者(77%)在研究天数中坚持肺活量测定≥70%,50/60名参与者(83%)坚持脉搏氧饱和度测定。41/60 名参与者(68%)的肺活量测量每周记录次数≥ 3 次,43/60 名参与者(72%)的脉搏血氧仪每周记录次数≥ 3 次。近期诊所和基线家庭肺活量测量的平均差异为 0.31 升(± 0.72)。根据 ERS/ATS 肺活量测定标准,85.7%(IQR 63.9-92.6%)的患者的家庭肺活量测定结果是可接受或可用的。ILD-GAP 评分与坚持肺活量测定和血氧饱和度测定之间呈正相关(rho 分别为 0.24 和 0.38)。临床团队坚持每周监测的比例为 80.95%(IQR 64.19-95.79)。所有回答体验问卷的参与者(n = 33)都认为远程测量操作简单,75%的参与者希望在研究结束后继续监测他们的肺活量。经过 3 个月的实践证明,在 ILD 临床服务中对患者的日常家庭肺活量测量和脉搏血氧监测进行远程监控是可行的。对于年龄较大或病情较重的参与者来说,远程监测可能更容易接受。 Clinicaltrials.gov NCT04850521 已于 2021 年 4 月 20 日注册。
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Feasibility and acceptability of remotely monitoring spirometry and pulse oximetry as part of interstitial lung disease clinical care: a single arm observational study
Remote monitoring of patient-recorded spirometry and pulse oximetry offers an alternative approach to traditional hospital-based monitoring of interstitial lung disease (ILD). Remote spirometry has been observed to reasonably reflect clinic spirometry in participants with ILD but remote monitoring has not been widely incorporated into clinical practice. We assessed the feasibility of remotely monitoring patients within a clinical ILD service. Prospective, single-arm, open-label observational multi-centre study (NCT04850521). Inclusion criteria included ILD diagnosis, age ≥ 18 years, FVC ≥ 50% predicted. 60 participants were asked to record a single spirometry and oximetry measurement at least once daily, monitored weekly by their local clinical team. Feasibility was defined as ≥ 68% of participants with ≥ 70% adherence to study measurements and recording measurements ≥ 3 times/week throughout. A total of 60 participants were included in the analysis. 42/60 (70%) were male; mean age 67.8 years (± 11.2); 34/60 (56.7%) had idiopathic pulmonary fibrosis (IPF), Median ILD-GAP score was 3 (IQR 1–4.75). Spirometry adherence was achieved for ≥ 70% of study days in 46/60 participants (77%) and pulse oximetry adherence in 50/60 participants (83%). Recording ≥ 3 times/week every week was provided for spirometry in 41/60 participants (68%) and pulse oximetry in 43/60 participants (72%). Mean difference between recent clinic and baseline home spirometry was 0.31 L (± 0.72). 85.7% (IQR 63.9–92.6%) home spirometry attempts/patient were acceptable or usable according to ERS/ATS spirometry criteria. Positive correlation was observed between ILD-GAP score and adherence to spirometry and oximetry (rho 0.24 and 0.38 respectively). Adherence of weekly monitoring by clinical teams was 80.95% (IQR 64.19–95.79). All participants who responded to an experience questionnaire (n = 33) found remote measurements easy to perform and 75% wished to continue monitoring their spirometry at the conclusion of the study. Feasibility of remote monitoring within an ILD clinical service was demonstrated over 3 months for both daily home spirometry and pulse oximetry of patients. Remote monitoring may be more acceptable to participants who are older or have more advanced disease. clinicaltrials.gov NCT04850521 registered 20th April 2021
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Respiratory Research
Respiratory Research 医学-呼吸系统
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1.70%
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期刊介绍: Respiratory Research publishes high-quality clinical and basic research, review and commentary articles on all aspects of respiratory medicine and related diseases. As the leading fully open access journal in the field, Respiratory Research provides an essential resource for pulmonologists, allergists, immunologists and other physicians, researchers, healthcare workers and medical students with worldwide dissemination of articles resulting in high visibility and generating international discussion. Topics of specific interest include asthma, chronic obstructive pulmonary disease, cystic fibrosis, genetics, infectious diseases, interstitial lung diseases, lung development, lung tumors, occupational and environmental factors, pulmonary circulation, pulmonary pharmacology and therapeutics, respiratory immunology, respiratory physiology, and sleep-related respiratory problems.
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