Cystic Fibrosis Clinical Trial
Official title:
Using Remote Telemonitoring to Detect Early Decline in Lung Function & Streamline Clinics in Adults With Cystic Fibrosis
Lung Health research study (Development of a predictive model) - To determine whether the I-neb breathing parameters (flow data) can act as a surrogate marker for lung function (Forced Expiratory Volume in 1 second FEV1) hence allow early detection of decline in lung function in cystic fibrosis patients.
1. Initial phase of the study will involve retrospective data collection, to review 36
months of retrospectively collected clinic time data (i.e. total length of appointment,
length of time seen by each discipline, waiting time). This data is routinely collected
and displayed in run charts. It will be used to allow an understanding of the baseline
variability in a standard un-streamed clinic and whether distinct patient
sub-populations can be identified i.e. red (complicated and time consuming) and green
(simple and rapidly processed) streams. These data may suggest a starting structure for
clinic slot lengths and provide a baseline comparator for the subsequent bespoke clinic
structures.
2. In the prospective intervention phase, To recruit 50 participants to take part in the
bespoke clinics using a home spirometer, weighing scales, and Bluetooth enabled I-neb
providing breathing parameter and adherence data.
3. Participants' baseline routinely collected demographics (age, gender, genotype) and
clinical data (including comorbidities, number of intravenous antibiotic days and
clinic attendances per year, and treatment regime) will be recorded.
4. At baseline participants will be asked to complete the Patient Activation Measure
questionnaire. This patient-reported measure is a powerful reliable tool which has been
validated in the UK24. It involves 13 quick questions to identify a patient's
knowledge, skills, and confidence in managing their own health and health care.
5. Participants will be asked to measure lung function and weight one week prior to
clinic. The I-neb adherence and flow data will be routinely captured and transferred.
6. Prior to clinic when this data is collected participants will be asked the EQ-5D-5L as
before, if they require a repeat prescription, and whether there are any issues they
would like to focus on when they attend for their consultation.
7. This data will then be reviewed to determine which stream patients would be predicted
to need to require. i.e. adherence support, diagnostic, or stable brief review.
8. Following review the standard clinic process will be analysed to see whether the
streaming would have been appropriate and if it could have potentially saved time and
resources.
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