Utility of remote supervised at-home spirometry for diagnosis and monitoring of airways disease in primary care

Research question What is the utility of remote supervised at-home spirometry for the diagnosis and monitoring of airways disease in primary care during COVID-19 times? And Is home spirometry feasible for use by healthcare providers in primary care?BackgroundSpirometry is essential in the proper diagnosis of airways disease. Due to COVID-19, the use of office spirometry is contraindicated in many countries. This is because the aerosols generated during the maneuver may spread the COVID-19 infection. In recent years, handheld spirometry linked to phones/apps has been developed for study purposes and remote monitoring. This study aims to assess the utility of spirometers for the diagnosis and monitoring in primary care during COVID-19 (and beyond).Possible methodology: (eg research methods, design, population, recruitment, funding):We plan to recruit 15 general practices and provide these practices with a “spirometry home assessment box”. This box will contain: 1. Nuvoair spirometer, 2. A disposable turbine, 3. Mobile phone set up for the spirometer, 4. Salbutamol dosisaerosol + spacer and 5. Manual. A cleaning protocol will be provided for the practice. Per practice, 3-5 consecutive patients where spirometry is indicated will be included. Patients will take the box home and, if needed, a video connection from the Nuvoair app between the patient and practice nurse can be established for coaching during the spirometry. Quality of the spirometry will be assessed by lung function technicians according to ERS/ATS criteria similar to the FOCUS study (https://doi.org/10.1038/s41533-020-0177-z). Interviews will be held with 10 patients for usability and 5 nurses to assess the feasibility and usability. Questions to discussWhat are relevant topics for the interviews? Any suggestions to the design? Only diagnosis? Or also monitoring? Declaration of Interest This study is funded by Boehringer Ingelheim Netherlands BV References and Clinical Trial Registry Information https://doi.org/10.1038/s41533-020-0177-z