The Feasibility of Home Lung Function Testing During the COVID-19 Pandemic for Asthma Diagnosis in Canada: Rationale and Study Design

05 Aug 2021
Respiratory conditions
  • COVID-19
Type of resource
Dublin 2021
Irvin Mayers, University of Alberta, Canada
Clinical Research Results Implementation Science/Service Development Aim: To determine whether home-based spirometry using telehealth supervision can be used to diagnose asthma in pulmonary function testing (PFT)-naïve patients.Brief outline of context: Clinical assessment and PFT are essential for asthma diagnosis and ongoing management; however, use of PFT during the pandemic in Canada has been curtailed due to risk of COVID-19 transmission. Delay in administering PFTs leads to uncertainty, poor diagnostic accuracy, and increased exacerbation risk in asthma patients. Therefore, we propose a novel approach to asthma diagnosis using home-based spirometry overseen by asthma educators using telehealth.Brief description of the change:Home PFT using SpiroCheck monitors can be used as an alternative to in-person PFT to provide a formal asthma diagnosis. In this pilot study, new patients (≥18 years old) referred to the telehealth program at the University of Alberta will be included if they can follow instructions in English and have a home internet connection with a web camera. Patients will receive a SpiroCheck monitor and a β2-agonist inhaler. During a telehealth visit, an asthma educator will coach patients on SpiroCheck usage; assess patients’ quality of life (QOL), symptom control, and asthma-specific QOL using validated questionnaires; transcribe measured forced expiratory volume in 1 s and forced vital capacity; supervise four inhalations of the β2-agonist; and review current asthma medications used. Results will be transmitted to the physician-of-record to help guide therapy. After 4 weeks, assessments will be repeated via telehealth (Figure 1).Strategy for change:Patient recruitment is ongoing, and the feasibility of home PFT will be determined by evaluating the number of patients diagnosed with asthma per the American Thoracic Society spirometry criteria. Home PFT can be useful even post-pandemic, particularly in areas with limited access to PFT, and for the diagnosis and management of asthma and other diseases, including chronic obstructive pulmonary disease. Research Ideas on Respiratory Conditions and Tobacco Dependency Abstract Declaration of Interest References and Clinical Trial Registry Information