Remote monitoring of cystic fibrosis lung disease in children and young adults.

Aim: Cystic fibrosis (CF) care increasingly demands flexible and personalised approaches, particularly with the growing role of telemedicine in disease management. This study aimed to evaluate the use of home-based spirometry and antibiotic monitoring for assessing lung function trends and treatment patterns in individuals with CF.

Method: Individuals aged 0-25 years from seven Swedish CF centres participated in 12 months of routine CF care, digitally recording antibiotic usage and performing home spirometry (aged ≥5 years). Home spirometry sessions were graded according to ATS/ERS criteria, with A-C representing high-quality sessions. Longitudinal FEV₁ trends from home and hospital spirometry were analysed using linear mixed effects models, adjusting for clinical stability.

Results: Of 126 invited participants, 110 were enrolled and followed for a median (range) duration of 12 months (9-17). A total of 779 usable home spirometry sessions were conducted, with 388 sessions (50 %) from 80 out of 95 (84 %) participants aged ≥5 years graded as high-quality. Mean (95 % CI) FEV₁ was (86-92 %) for home spirometry and 88 % (85-90 %) for hospital spirometry. After adjusting for clinical stability and including only high-quality home spirometry data, the mean difference was 0.6 % (-3.8 %-5.0 %, p=0.78). The mean annual rate of FEV₁ decline was -0.48 % (-1.29-0.32 %) for home spirometry and -0.18 % (-0.77-0.41 %) for hospital spirometry, with no statistically significant difference.

Conclusion: High-quality home spirometry measurements, adjusted for clinical stability and antibiotic usage, may provide lung function levels and trends closely comparable to hospital spirometry.