The Impact of Attention Deficit Hyperactivity Disorder on Home Spirometry and Other Parameters in People With Cystic Fibrosis.

Abstract

Background: Attention deficit hyperactivity disorder (ADHD) is a common neurodevelopmental disorder leading to challenges in treatment adherence. Despite emerging evidence on the prevalence of ADHD in pwCF and its potential impact on treatment adherence, there remains a gap in knowledge regarding the impact of ADHD on disease monitoring behaviours in the telehealth era, particularly through the use of portable home spirometry.

Methods: This retrospective study analysed home spirometry data in a large adult CF centre from 2020 to 2024. The study included 17 pwCF with a confirmed ADHD diagnosis and 34 age- and sex-matched controls without ADHD. Home spirometry was conducted using the AirNext device (NuvoAir, Stockholm, Sweden).

Results: The prevalence of confirmed ADHD among 463 adult pwCF was 3.67%. PwCF with ADHD demonstrated a higher median number of spirometry sessions than the control group (28 [IQR: 20-55] vs. 22 [IQR: 14-41]; p = 0.31). Longitudinally, the frequency of spirometry performed appears similar in both ADHD and control group, with no observed difference in spirometry quality. Proportions of patients engaging with spirometry were consistently higher in the ADHD group across the study period (p = 0.01). PwCF with ADHD were more likely to perform spirometry outside of standard clinic hours (32.6% vs. 25.5%; p < 0.01) and during weekends (12.3% vs. 9.8%; p < 0.01). Initiation of stimulant ADHD medications was associated with a reduction in spirometry frequency, aligning with non-ADHD controls (p = 0.04).

Conclusion: PwCF with ADHD performed spirometry at a similar level to those without ADHD, supporting the feasibility of home spirometry in this subgroup.