Study design (if review, criteria of inclusion for studies)
Randomized controlled trial
Participants
Sixty-one children with CF
Interventions
Children were randomly allocated to either supervised or unsupervised home spirometry following a detailed training session. Home spirometry was performed every 2 weeks for 12 weeks.
Outcome measures
Tests were assigned a quality factor (QF) using our laboratory grading system as per American Thoracic Society/European Respiratory Society standards, with tests marked from A to D, or Fail. In our laboratory, we aim for QF A in all spirometry tests, but report results of QF B or C with a cautionary note. QF A was, therefore, the primary outcome, and QF A-C, the secondary outcome.
Main results
Sixty-one patients were enrolled; 166 measurements were obtained in the supervised group, and 153 in the unsupervised group. Significantly more measurements achieved QF A in the supervised compared to unsupervised group (89% vs. 74%; pâ=â<0.001), while proportions reaching Grade A-C were similar (99% vs. 95%; pâ=â0.1). All significant declines in spirometry results had a clinical rather than technical reason. Family/patient feedback for both arms was very positive.
Authors' conclusions
These results suggest that home spirometry in children should ideally be remotely supervised by a physiologist, but acceptable results can be obtained if resources do not allow this, provided that training is delivered and results monitored according to our protocol.
Keywords: Adolescent; Adult; Child; training; non pharmacological intervention - psyco-soc-edu-org;