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Home Spirometry in Primary Care: an Implementation Study

Completed
Conditions
COPD Asthma
Interventions
Device: NuvoAir platform
Registration Number
NCT05162157
Lead Sponsor
General Practitioners Research Institute
Brief Summary

Rationale: Spirometry is essential in the diagnosis of airway disease and can be useful in monitoring patients. Despite the essential role, spirometry remains largely underused in primary care. Due to Coronavirus disease (COVID-19), the use of office spirometry is contraindicated in many countries. Furthermore, spirometric devices are costly and personnel requires special training. Referral for spirometry increases the cost for patients and lowers the feasibility. Part of the reason for underdiagnosis of airway disease are the specific situations (such as exercise-induced asthma) in which spirometry in office setting might not reveal abnormalities. In recent years, handheld spirometry linked to phones/apps has been developed for study purposes and remote monitoring.

Objective: To study the feasibility, quality and added value of at-home spirometry for the diagnosis and monitoring of asthma and Chronic Obstructive Pulmonary Disease (COPD) in primary care.

Detailed Description

Not available

Recruitment & Eligibility

Status
COMPLETED
Sex
All
Target Recruitment
144
Inclusion Criteria
  • Age ≥ 16 years
  • Spirometry indication
  • Able and willing to use at-home spirometry
Exclusion Criteria
  • On the discretion of the recruiting clinician if he or she deems a patient not eligible.
  • Inability to understand and sign the informed consent form
  • Known previous inability to perform spirometry
  • Contraindications to perform spirometry as listed in the standardization of Spirometry 2019 update (Graham et al., 2019)

Study & Design

Study Type
OBSERVATIONAL
Study Design
Not specified
Arm && Interventions
GroupInterventionDescription
at-home spirometryNuvoAir platformThis group performs spirometry at home with the Nuvoair spirometer
Primary Outcome Measures
NameTimeMethod
Clinically useful spirometry1 day: Participant will perform one spirometry session including several manoeuvres

Occurrence (expressed as percentage of patients) of home spirometry being graded A, B or C, following technical standards of the American Thoracic Society and the European Respiratory Society (Graham, B.L. et al.)

Successful spirometry1 day: Participant will perform one spirometry session including several manoeuvres

Occurrence (expressed as percentage of patients) of home spirometry being graded A, following technical standards of the American Thoracic Society (ATS) and the European Respiratory Society (ERS) (Graham, B. L. et al.)

Secondary Outcome Measures
NameTimeMethod
Healthcare professional's view on the added value of home spirometryImmediately after completion of spirometry measurements

Individual scores on a 5-points Likert-scale of questions asked to healthcare professionals regarding the added value of home spirometry for monitoring and diagnosing of asthma and COPD (the Likert-scales range from strongly disagree to strongly agree)

Patient's view on the added value of home spirometryImmediately after completion of spirometry measurements

Individual scores on a 5-points Likert-scale of questions asked to the patient on the benefit of home spirometry (the Likert-scales range from strongly disagree to strongly agree)

Quality of spirometry, following ATS/ERS grading of spirometry1 day: Participant will perform one spirometry session including several manoeuvres

Quality of spirometry performed as rated by the device application using the American Thoracic Society /European Respiratory Society (ERS) grading of spirometry on a scale from A (≥3 acceptable and repeatability within 0.150 litre) to F (zero acceptable or usable) (Graham, B. L. et al.)

Quality of spirometry curves as scored by independent spirometry professionals1 day: Participant will perform one spirometry session including several manoeuvres

Quality as assessed by visual inspection of curves and values by two or three (in case of disagreement between the first two) independent spirometry professionals whether manoeuvres are acceptable or not

Degree of feasibility of home spirometry as rated by the healthcare professionalImmediately after completion of spirometry measurements

Individual scores on a 5-points Likert-scale of questions on the feasibility of home spirometry, scored by health professionals, including four questions of a validated tool as published by Weiner et al.

Trial Locations

Locations (2)

GPRI

🇳🇱

Groningen, Netherlands

Karolinska Institute

🇸🇪

Solna, Stockholm, Sweden

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