Home Monitoring vs. Traditional Care in CF: Year-Long Study Results
A study of home monitoring vs. traditional cystic fibrosis care in 267 patients age fourteen and older showed that after a year, FEV1 decline is similar in both models, though exacerbations are detected earlier in the home monitoring group. Home monitoring consisted of twice weekly electronic logging of spirometry and symptoms. Traditional care consisted of clinic visits every three months and patients contacting clinics if worse symptoms were noted.
Read more about the study here: Home Monitoring in CF to Identify and Treat Acute Pulmonary Exacerbations: eICE Study Results
In the study, the Early Intervention arm had patients measure home spirometry and symptoms electronically twice a week. CF centers were notified if a participant met criteria for an exacerbation, and patients were contacted to assess if treatment was required.
In contrast, the Usual Care arm patients were seen every three months and were asked to contact centers if they were concerned about worsening pulmonary symptoms.
Researchers looked at the 52 week change in FEV1, as well as time to first exacerbation and subsequent exacerbation, quality of life, and change in weight.
“Main Results: 267 patients were randomized and the study arms were well matched at baseline. There was no significant difference between study arms in 52 week mean change in FEV1 slope (mean slope difference=0.00L, 95%C.I.=-0.07-0.07, p=0.99). The Early Intervention arm detected exacerbations more frequently than Usual Care (time to first exacerbation, HR=1.45, 95%C.I.=1.09-1.93, p=0.01). Adverse events were not significantly different between treatment arms.”
While the Early Intervention and Traditional Care arms had similar decline in FEV1, further studies might look at changes in the Lung Clearance Index, explained here, which detects damage to lungs in the earlier stages of disease. Moreover, it is possible that FEV1 changes could take longer than one year to manifest or treatment time may be shorter when exacerbations are detected earlier.
It is unclear from the study abstract whether adopting the early intervention approach was difficult or easy for patients and providers, and whether changes in weight were the same in both study arms.