P106 The impact of technician-led virtual spirometry sessions on the availability and quality of home spirometry results in a virtual Cystic Fibrosis clinic

Abstract

Introduction Spirometry is an essential component of monitoring the health of people with Cystic Fibrosis (CF). Since the Covid-19 pandemic, most consultations have been conducted via video conferencing. All appropriate patients were given MIR Spirobank® portable spirometers (MIR Medical International Research Srl) and asked to send in readings before each clinic. We noticed a fall in the number and quality of spirometry reports available to clinicians in virtual clinics compared to face-to-face reviews. We set out to improve this through a Respiratory Physiologist-led virtual spirometry clinic. Methods Spirobank® spirometry reports (including grading of quality using ATS/ERS criteria¹) provided by patients attending virtual CF clinics in our CF centre in January 2021 were reviewed. Following this review, a virtual spirometry clinic was established (running before the main clinic) in which the patient performs spirometry via the ‘Live Video Exam’ app on their mobile device, coached by a Physiologist who is able to see the patient via their mobile phone camera and view spirometry flow loops in real time, downloading results ready for the subsequent clinic. Review of spirometry available for clinics in May 2021 was then performed and the number and quality of reports available compared. Results Spirometry reports were available for 35 out of 70 appointments for patients with Spirobank® devices in January 2021, of which 26/70 (37%) were ATS grade A or B. In May 2021, 50 patients with devices had clinic appointments: 9 provided reports independently (7 grade A or B), 37 were coached by a physiologist (31 A or B), and 4 did not attend or declined a coaching session. Conclusion Without coaching, only 37% patients with a Spirobank® device provided ATS grade A or B spirometry for virtual CF clinics; this increased to 76% with the introduction of pre-clinic online Respiratory Physiologist coaching sessions. We plan to review how the number and quality of reports provided with and without coaching changes as patient experience in the use of home spirometers increases. Reference Standardization of Spirometry 2019 Update. American Journal of Respiratory & Critical Care Medicine 2019;200(8):e70–e88.