Abstract
Background Acute exacerbations and disease progression in interstitial lung disease (AE-ILD) pose important challenges to clinicians and patients. AE-ILD are variable in presentation but may result in rapid progression of ILD, respiratory failure and death. However, in many cases AE-ILD may go unrecognised so that their true impact and response to therapy is unknown. The potential for home monitoring to facilitate early, and accurate, identification of AE and/or ILD progression has gained interest. With increasing evidence available, there is a need for a systematic review on home monitoring of patients with ILD to summarise the existing data.
Aim To systematically evaluate the evidence for use of home monitoring for early detection of exacerbations and/or progression of ILD.
Method We searched Ovid-EMBASE, MEDLINE, and CINAHL using MeSH terms in accordance with the PRISMA guidelines. PROSPERO registration number (CRD42020215166).
Results Thirteen studies comprising 968 patients have demonstrated that home monitoring is feasible and of potential benefit in patients with ILD. Nine studies reported that mean adherence to home monitoring was greater than 75%, and where spirometry was performed there was a significant correlation (r=0.72–0.98, p<0.001) between home and hospital-based readings. Two studies suggested that home monitoring of Forced Vital Capacity (FVC) might facilitate detection of progression in idiopathic pulmonary fibrosis (IPF).
Conclusion Despite the fact that individual studies in this systematic review provide supportive evidence suggesting the feasibility and utility of home monitoring in ILD, further studies are necessary to quantify the potential of home monitoring to detect disease progression and/or acute exacerbations.
Footnotes
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Conflict of interest: M. Althobiani has nothing to disclose.
Conflict of interest: Rebecca A Evans has nothing to disclose.
Conflict of interest: J.S. Alqahtani has nothing to disclose
Conflict of interest: A.M. Aldahahir has nothing to disclose.
Conflict of interest: Dr. Russell reports grants, personal fees and other from Boehringer Ingelheim , personal fees from Hoffman La Roche,outside the submitted work. AMR is a NIHR 70@70 Senior Research Fellow. The views expressed in this publication are those of the author(s) and not necessarily those of the National Institute for Health Research or the Department of Health and Social Care.
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