(135) Electronic home monitoring of children with cystic fibrosis to detect and treat acute pulmonary exacerbations and its effect on 1-year FEV₁ loss

Background: Patients with cystic fibrosis (CF) have recurrent respiratory tract infections and acute pulmonary exacerbations (PEx) cause loss of lung functions and thus decrease life expectancy. One of the signs of a PEx is decline in forced expiratory volume in 1 second (FEV₁). Early detection of impairment in pulmonary function tests (PFT) allows early diagnosis and treatment of PEx. We aimed to investigate the effect of the use of electronic home spirometry in patients with CF on number of PEx and 1 year-FEV₁ (% predicted, pp) change.

Methods: This is a randomized, one year prospective study. CF patients between 6-18 years of age, who could perform spirometry previously and have a smartphone were included in the study. Eligible patients were randomized into 2 groups as home spirometry group (HSG) and usual care group (UCG). Patients in HSG performed 2 PFTs per week and the results were evaluated by registered CF nurse for decline in FEV₁ simultaneously. The number of the PEx, days in hospital for PEx and days on oral antibiotics for PEx were evaluated from patients’ records and compared with the datas of the previous year. At the beginning and end of the study, health related quality of life (QOL) questionnaire for CF patients and lung clearance index (LCI) were applied.

Results: Each group included 30 patients. 22 patients in HSG and 24 patients in UCG have completed the study. The median age was 13.45 years (25-75.percentiles 11.68-14.95) in HSG and 12.70 years (25-75.percentiles 10.63-15.48) in UCG. Median (25-75.percentiles) of 1-year FEV₁ pp change was 0.95 (-2.61 - 6.73) in HSG and -0.41 (-3.68 – 3.09) in UCG (p=0.27). The results are summarized in Table 1.

Conclusions: Electronic home monitoring of CF patients by spirometry and early treatment of PEx may result in slower decline in lung functions. That will probably have a beneficial effect on QOL. Full results including QOL analysis will be available before the conference.

Acknowledgements: There is no source of financial grant and other funding.

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