Rapid implementation of telemedicine intervention for cystic fibrosis shows success
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Rapid implementation of a cystic fibrosis care model including telemedicine was successful for monitoring lung function and identifying exacerbations during the COVID-19 pandemic, according to data published in Chest.
The care model also enabled monitoring of BMI and decreased use of antibiotics.
“Telemedicine increases access to care for adults with cystic fibrosis living in regions remote to a cystic fibrosis specialty center, but routine use of telemedicine did not gain widespread traction until the COVID-19 pandemic,” Lindsay A.L. Somerville, MD, pulmonologist in the division of pulmonary and critical care at the University of Virginia, Charlottesville, and colleagues wrote. “In March of 2020, the adult cystic fibrosis team at the University of Virginia rapidly transitioned from in-person clinical encounters to a cystic fibrosis care model that included interdisciplinary telemedicine using the HIPAA-compliant video communication.”
Somerville and colleagues reported clinical outcomes of the care model that included interdisciplinary telemedicine as compared with in-person care for patients with cystic fibrosis during the pandemic.
The prospective, observational study included 110 adults with cystic fibrosis (mean age, 35 years; 54% women) enrolled from March 2020 to March 2021. The researchers also analyzed pre-pandemic data (March 2019-March 2020).
Telemedicine visits were defined as clinical encounters via secured video communication. Hybrid visits were defined as in-person physician evaluations with in-clinic video communication. In-person visits were defined as clinical encounters with in-person physicians only.
The primary outcome included lung function, BMI, cystic fibrosis exacerbations and antibiotic use.
Ninety-five percent of patients with cystic fibrosis had access to telemedicine. Telemedicine accounted for 64% of encounters, hybrid visits accounted for 28% of encounters and in-person visits accounted for 7% of encounters.
Mean FEV1 percent predicted increased from 69.27% to 73.55% during the pandemic compared with the pre-pandemic year (P < .01), BMI increased from 25 kg/m2 to 26 kg/m2 (P < .001) and antibiotic use decreased from 316 episodes to 124 episodes (P < .0001), the researchers reported.
According to the researchers, the introduction of elexacaftor/tezacaftor/ivacaftor (Vertex Pharmaceuticals) triple therapy in October 2019 improved lung function and cystic fibrosis exacerbation rates, and said the significant lung function improvement observed during the pandemic year was likely attributed to this therapy. Triple therapy likely contributed to the overall clinical stability in patients with cystic fibrosis during the COVID-19 pandemic, the researchers noted.
“The authors previously demonstrated that implementation of telemedicine during the COVID-19 pandemic reduced patient and staff interactions and by doing so preserved personal protective equipment,” the researchers wrote. “Here we demonstrate that real-world clinical outcomes of a clinical care model with interdisciplinary telemedicine are similar to the classical clinical care model, and in the time of a pandemic, this model may offer significant advantages to in-person care.”