Use of Telehealth Technology for Home Spirometry after Lung Transplantation: A Randomized Controlled Trial

Abstract

Context Complications often occur during the early phase after lung transplantation, and rapid diagnosis is vital. Home spirometry is used to detect early changes in graft function. Bluetooth-equipped cell phones are easy to use and facilitate data transfer from home spirometry. Objective To explore use of home spirometry with Bluetooth data transfer in outpatient lung transplant recipients. Design Single-center prospective randomized controlled trial. Intervention Fifty-six patients were randomized either to home spirometry with data transfer via Bluetooth-equipped cell phones or to home spirometry alone before discharge after lung transplantation. In the Bluetooth group, results were transferred to a database capable of generating alarm messages. Main Outcome Measures Time from onset of symptoms to physician consultation during the first 6 months after lung transplantation was the primary end point. Results Adherence to home spirometry was 97.2% in the Bluetooth group and 95.3% in the home spirometry alone group ( P= .73). Median time to first consultation ( P = .60) and frequency of consultation ( P = .06) did not differ significantly in the 2 groups. Mean scores on the Hospital Anxiety and Depression Scale were lower in patients in the Bluetooth group (1.5; range, 0.0–4.0) than in the home spirometry alone group (4.0; range, 2.0–6.0; P = .04). Conclusion Home spirometry with data transfer is feasible and safe in lung transplant recipients. Compared with home spirometry alone, additional data transfer was equally effective regarding the time interval from symptom onset to consultation. Patients in the Bluetooth group reported less anxiety, which may improve emotional well-being.