The effect of telemonitoring in preventing lung function decline in cystic fibrosis

<bold>Aim:</bold> To evaluate the level of adherence to lung function telemonitoring with home spirometry among people with CF (pwCF); to assess the effect of home spirometry added to usual care vs. usual care in lung function decline. <bold>Methods:</bold> This was a randomized, two-arm trial in pwCF, children and adults, over 26 weeks. The study population consisted of two groups: 1. Usual Care (UC) group: pwCF were examined regularly in cystic fibrosis outpatient clinics; 2. Home Spirometry (HS) group: the telemonitoring program was performed in addition to their regular visits by measuring home spirometry weekly. Electronic lung function devices connected with an electronic platform accessible from the CF Unit were used. <bold>Results:</bold> 104 pwCF were included in our study, 52 in the HS group and 52 in the UC group, with a median age of 16 years (IQR: 10.8 to 20.2). The weekly adherence in the telemonitoring program was 23.1%. Only 23% of the HS performed a spirometry once per week in more than 80% of their chances of spirometry follow-up, while 52% performed a spirometry in more than 50% of their chances. Body Mass Index (BMI) was not found to present a significant change in 26 weeks between study arms, with a change of HS and UC group 0.53 (IQR: -0.17 to 0.98) and 0.25 (IQR: -0.30 to 0.65) accordingly (p: 0.22). There was no significant change between study arms in the 26-week mean change in FEV1pp, between HS and UC group 2% (IQR: -6 to 14.2) and 2% (IQR: -7 to 8) (p: 0.578), and change in FVC% 2% (IQR: -8.25 to 11.5) and 0% (IQR: -7.25 to 9) (p: 0.569). <bold>Conclusion:</bold> Despite adequate adherence to the home spirometry program, no significant changes were found in BMI and lung function in the telemonitoring group.