Single-arm observational study of a mobile app + home spirometry in idiopathic pulmonary fibrosis

Abstract

Daily home spirometry may be useful in assessing idiopathic pulmonary fibrosis (IPF). patientMpower (pMp) is a mobile application for IPF patients to record medicines adherence, activity, FVC, dyspnea (mMRC score), impact of IPF on daily life [Patient Reported Outcome Measure (PROM)] & other outcomes. pMp captures home spirometry via Bluetooth-linked Spirobank Smart spirometer (MIR, Rome, Italy). IPF patients attending a nurse-led clinic were asked to take part in this prospective, open, single-arm study (NCT03544598).

Objectives: assess (1) longitudinal trends of home FVC & PROM (2) correlation of home- vs. clinic-measured FVC & PROM. pMp & spirometer pairing installed on patients’ smartphones at baseline. Patients recorded FVC (seated; 1/d) & PROM (1/wk) on pMp until next routine clinic visit (usual care throughout). Other data (e.g. mMRC, symptoms, oximetry, oxygen flow-rate, adherence, weight) recorded on pMp if they wished. FVC, mMRC & PROM assessed at clinic at start & end. 20 patients entered [16 male; age: 66.6±9.0Y, baseline predicted clinic FVC: 91.9%±17.0%, median mMRC: 2]. Baseline scores indicated impact of IPF on all PROM domains. 14 completed to date. Baseline clinic FVC: 3.36±0.81L with FVC: 3.37±0.89L at follow-up. Stability was reflected in PROM scores. Median follow-up: 117d [interquartile range (IQR): 111-125] & adherence to home spirometry: 87% (IQR: 39-94%). In questionnaires, 8/9 patients wanted to continue pMp & would recommend to others. 9/14 patients continued pMp+home spirometry after study end. IPF patients may wish to use pMp to record spirometry & other outcomes as part of usual care. Daily home spirometry was feasible & acceptable for most patients.