Feasibility, quality and added value of unsupervised at-home spirometry in primary care

At-home spirometry could provide added value for the diagnosis and monitoring of obstructive pulmonary disease in primary care. However, it is unknown whether implementation in a real-world setting is practicable and produces good quality spirometry. We studied feasibility, quality and added value of at-home spirometry in primary care practices in the Netherlands and Sweden. Adults with an asthma- or COPD-related spirometry indication were provided with equipment to perform unsupervised spirometry at-home. Differences in FEV₁ and FVC-values from home and general practice were compared, and questionnaires on feasibility were completed by participants and healthcare professionals (HCPs). Of 140 participants, 89.3% completed a home spirometry session, of whom 59.2% produced acceptable spirometry. Overall, HCPs and participants rated home spirometry as feasible and of added value for asthma and COPD monitoring in primary care, though less helpful for diagnostic purposes. A small mean difference in spirometry results was observed, with FEV₁ and FVC at-home being 0.076 and 0.094 L higher than at the GP office, respectively.