Online home monitoring improves psychological well-being in patients with IPF
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A comprehensive online home monitoring program for patients with idiopathic pulmonary fibrosis did not improve health-related quality of life, but improved patients’ psychological well-being.
“This was the first-ever randomized controlled trial of an eHealth intervention in idiopathic pulmonary fibrosis. This study has two important take-home messages. First, we believe that home monitoring has the potential to enable personalized treatment for IPF in the future, and second, home spirometry can be a reliable tool for frequent monitoring of patients in research and daily practice,” Marlies S. Wijsenbeek, MD, PhD, of the department of respiratory medicine at Erasmus University Medical Center in Rotterdam, the Netherlands, who conducted the research with Catharina Moor, PhD, and colleagues, told Healio. “Frequent outpatient clinic visits can be very burdensome for patients with IPF who have to deal with symptoms as cough, dyspnea and impaired exercise tolerance. An online home monitoring program can enable remote follow-up of patients with IPF and reduce the burden of frequent hospital visits for patients and their caregivers.”
Researchers conducted a multicenter, randomized controlled trial that enrolled 90 patients (mean age, 71 years; 91% men) with newly treated IPF from January 2018 to January 2019. Patients were randomly assigned to standard care (n = 44) or a home monitoring program plus standard care (n = 46) for 24 weeks. The home monitoring program included home spirometry, symptoms and side effect reporting, patient-reported outcome measures, a medical coach and e-consultations.
Primary endpoint was difference in change in King’s Brief Interstitial Lung disease (K-BILD) questionnaire score at week 24.
At 24 weeks, the researchers reported no significant difference in mean total K-BILD score, which increased by 2.7 points in the home monitoring group and by 0.03 points in the standard care group (between-group difference, 2.67 points; 95% CI, –1.85 to 7.17; P = .24).
Psychological domain score increased by 5.12 points in the home monitoring group compared with a decline of 0.48 points in the standard care group (between-group difference, 5.6 points; 95% CI, –1.13 to 12.3; P = .1).
In other results, medication adjustment occurred more often in the home monitoring group (1 vs. 0.3 adjustments per patient; 95% CI, 0.2-1.3; P = .027).
Patient satisfaction was high in the home monitoring group, with most patients noting that they would recommend the program to others, according to the results.
The researchers reported that home-based spirometry in this study was highly correlated with hospital-based spirometry over time.
“The current study was designed to assess the effects on a home monitoring program as add-on to standard care and not to replace outpatient clinic visits,” Wijsenbeek said.
“During the COVID-19 pandemic, we replaced the outpatient clinic visits by video consultations, using the online home monitoring program, in many patients with IPF. This seems to be a safe option to ensure the continuity of care for this patient group,” she said.
Still, “the long-term effects and impact on quality of care need to be evaluated in future studies,” Wijsenbeek said.
For more information:
Mariles Wijsenbeek, MD, PhD can be reached at m.wijsenbeek-lourens@erasmusmc.nl.