RT Journal Article
SR Electronic
T1 Telemedicine enhances quality of forced spirometry in primary care
JF European Respiratory Journal
JO Eur Respir J
FD European Respiratory Society
SP 1313
OP 1318
DO 10.1183/09031936.00168010
VO 39
IS 6
A1 Felip Burgos
A1 Carlos Disdier
A1 Elena Lopez de Santamaria
A1 Batxi Galdiz
A1 Núria Roger
A1 Maria Luisa Rivera
A1 Ramona Hervàs
A1 Enric Durán-Tauleria
A1 Judith Garcia-Aymerich
A1 Josep Roca
YR 2012
UL http://erj.ersjournals.com/content/39/6/1313.abstract
AB 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.