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Telemedicine enhances quality of forced spirometry in primary care

Felip Burgos, Carlos Disdier, Elena Lopez de Santamaria, Batxi Galdiz, Núria Roger, Maria Luisa Rivera, Ramona Hervàs, Enric Durán-Tauleria, Judith Garcia-Aymerich, Josep Roca on behalf of e-Spir@p group
European Respiratory Journal 2012 39: 1313-1318; DOI: 10.1183/09031936.00168010
Felip Burgos
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  • For correspondence: fburgos@ub.edu
Carlos Disdier
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Elena Lopez de Santamaria
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Batxi Galdiz
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Núria Roger
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Maria Luisa Rivera
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Ramona Hervàs
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Enric Durán-Tauleria
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Judith Garcia-Aymerich
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Josep Roca
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Abstract

Forced spirometry is pivotal for diagnosis and management of respiratory diseases, but its use in primary care is suboptimal. The aim of the present study was to assess a web-based application aiming at fostering high-quality spirometry in primary care.

This was a randomised controlled trial with 12 intervention primary care units (PCi) and six control units (PCc) studied over 12 months. All 34 naïve nurses (PCi and PCc) received identical training. The PCi units had access to educational material and remote expert support. Quality of spirometry and usability of the web application were assessed.

We included 4,581 patients (3,383 PCi and 1,198 PCc). At baseline, quality was similar (PCi 71% and PCc 67% high-quality tests). During the study, PCi showed higher percentage (71.5%) of high-quality tests than PCc (59.5%) (p<0.0001). PCi had 73% more chance of high-quality performance than PCc. The web application was better for assessing quality of testing than the automatic feedback provided by the spirometer. Healthcare professionals’ satisfaction and usability were high.

The web-based remote support for primary care by specialists generated a sustained positive impact on quality of testing. The study expands the potential of primary care for diagnosis and management of patients with pulmonary diseases.

  • Forced spirometry
  • information technology
  • primary care
  • quality control
  • telemedicine

Footnotes

  • Support Statement

    The study was supported by CIBERES, FIS grants 04/2728 and 04/2749, MAPFRE 2006, PII-EPOC (SEPAR), NEXES (Supporting Healthier and Independent Living for Chronic Patients and Elderly; grant CIP-ICTPSP- 2007-225025) and an unrestricted grant from Boheringer-Pfizer. J. Garcia-Aymerich has a researcher contract from the Instituto de Salud Carlos III (grant CP05/00118), Ministry of Health, Spain.

  • Statement of Interest

    Statements of interest for F. Burgos, C. Disdier and J. Roca, and for the study itself can be found at www.erj.ersjournals.com/site/misc/statements.xhtml

  • Received October 27, 2010.
  • Accepted September 15, 2011.
  • ©ERS 2012
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European Respiratory Journal: 39 (6)
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Telemedicine enhances quality of forced spirometry in primary care
Felip Burgos, Carlos Disdier, Elena Lopez de Santamaria, Batxi Galdiz, Núria Roger, Maria Luisa Rivera, Ramona Hervàs, Enric Durán-Tauleria, Judith Garcia-Aymerich, Josep Roca
European Respiratory Journal Jun 2012, 39 (6) 1313-1318; DOI: 10.1183/09031936.00168010

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Telemedicine enhances quality of forced spirometry in primary care
Felip Burgos, Carlos Disdier, Elena Lopez de Santamaria, Batxi Galdiz, Núria Roger, Maria Luisa Rivera, Ramona Hervàs, Enric Durán-Tauleria, Judith Garcia-Aymerich, Josep Roca
European Respiratory Journal Jun 2012, 39 (6) 1313-1318; DOI: 10.1183/09031936.00168010
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