(21) Feasibility of utilizing a modified menstrual tracking app to correlate menstrual cycles and cystic fibrosis symptoms among women with CF: Early findings of the MENSTRUAL study.

Background: The MENstrual Symptom Tracking to Understand and Assess (women) Living with CF (MENSTRUAL) study explores the feasibility of using a modified menstrual tracking smartphone application to track disease-specific symptoms during the menstrual cycle among women with cystic fibrosis (CF).

Methods: In this prospective cohort study, participants were recruited using social media, listservs, and through referrals from CF care centers. After completing a virtual training session, participants used a modified period tracking app on a daily basis to report if they had menstrual bleeding and the presence and severity of CF symptoms, such as lung congestion, coughing and hemoptysis. These symptoms were considered equal and were selected from a pre-set list developed by a multidisciplinary, patient-centered team of family practice, ob/gyn and CF care clinicians and women with CF. Participants tracked their daily symptoms for three consecutive months using the smartphone application. We received IRB approval and all participants provided informed consent.

Results: We were able to modify a smartphone application to track both each participant’s menstrual cycles and CF symptoms. Seventy-four women with CF participated in this study. Participants were 18-45 years old and from every region of the United States. Eighty percent of participants reported it was very easy to track CF symptoms using the smartphone application. Participants reported that it took them less than one minute to complete the daily track. Only 2 participants (2.7%) needed additional technical support utilizing the smartphone application. The smartphone application allowed us to tell where each participant was in her menstrual cycle and see if she had more frequent or severe CF symptoms. Preliminary analysis of the data suggests that during the luteal phase of the menstrual cycle there is an increase in the overall number and severity of CF symptoms.

Conclusions: Thisstudy suggests that a modified menstrual tracking smartphone application is feasible to study the intersection of menstrual and CF-related symptoms. While larger studies are needed, these results may inform CF clinical practice by demonstrating that women can use a smartphone application to anticipate menstrual cycle-related changes in CF symptomatology and share this tracking with their CF care clinicians. Also, these results may help focus future interventions to alleviate symptoms among menstruating women with CF. A menstrual tracking smartphone application could be utilized to identify trends in menstrual cycles and disease-specific symptoms to promote a personalized approach to CF care and research.

Acknowledgements: This work was supported by the Cystic Fibrosis Foundation [GODFRE20A0]

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