UCL Respiratory, University College London, London, UK.
Department of Respiratory Therapy, Faculty of Medical Rehabilitation Sciences, King Abdulaziz University, Jeddah, Saudi Arabia.
BMJ Open Respir Res. 2021 Dec;8(1). doi: 10.1136/bmjresp-2021-001088.
Clinicians and policymakers are promoting widespread use of home technology including spirometry to detect disease progression for patients with interstitial lung disease (ILD); the COVID-19 pandemic has accelerated this. Data collating clinicians' views on the potential utility of telehealth in ILD are limited.
This survey investigated clinicians' opinions about contemporary methods and practices used to monitor disease progression in patients with ILD using telehealth.
Clinicians were invited to participate in a cross-sectional survey (SurveyMonkey) of 13 questions designed by an expert panel. Telehealth was defined as home monitoring of symptoms and physiological parameters with regular automatic transmission of data from the patient's home to the clinician. Data are presented as percentages of respondents.
A total of 207 clinicians from 23 countries participated in the survey. A minority (81, 39%) reported using telehealth. 50% (n=41) of these respondents completed a further question about the effectiveness of telehealth. A majority of respondents (32, 70%) rated it to be quite or more effective than face-to-face visit. There were a greater number of respondents using telehealth from Europe (94, 45%) than Asia (51, 25%) and America (24%). Clinicians reported the most useful telehealth monitoring technologies as smartphone apps (59%) and wearable sensors (30%). Telehealth was most frequently used for monitoring disease progression (70%), quality of life (63%), medication use (63%) and reducing the need for in-person visits (63%). Clinicians most often monitored symptoms (93%), oxygen saturation (74%) and physical activity (72%). The equipment perceived to be most effective were spirometers (43%) and pulse oximeters (33%). The primary barriers to clinicians' participation in telehealth were organisational structure (80%), technical challenges (63%) and lack of time and/or workload (63%). Clinicians considered patients' barriers to participation might include lack of awareness (76%), lack of knowledge using smartphones (60%) and lack of confidence in telehealth (56%).
The ILD clinicians completing this survey who used telehealth to monitor patients (n=81) supported its' clinical utility. Our findings emphasise the need for robust research in telehealth as a mode for the delivery of cost-effective healthcare services in ILD and highlight the need to assess patients' perspectives to improve telehealth utility in patients with ILD.
临床医生和决策者正在推广广泛使用家庭技术，包括肺活量测定法，以检测间质性肺病（ILD）患者的疾病进展；COVID-19 大流行加速了这一进程。关于远程医疗在ILD 中的潜在效用的数据，收集临床医生的意见是有限的。
本调查研究了临床医生对使用远程医疗监测ILD 患者疾病进展的当代方法和实践的看法。
临床医生被邀请参加由专家小组设计的 13 个问题的横断面调查（SurveyMonkey）。远程医疗是指在家中监测症状和生理参数，并定期自动将患者家中的数据传输给临床医生。数据以回答者的百分比表示。
共有来自 23 个国家的 207 名临床医生参加了这项调查。少数（81 名，39%）报告使用远程医疗。其中 50%（n=41）的受访者进一步回答了远程医疗的有效性问题。大多数受访者（32，70%）认为它比面对面访问更有效或更有效。来自欧洲（94，45%）的使用远程医疗的受访者多于亚洲（51，25%）和美洲（24%）。临床医生报告最有用的远程医疗监测技术是智能手机应用程序（59%）和可穿戴传感器（30%）。远程医疗最常用于监测疾病进展（70%）、生活质量（63%）、药物使用（63%）和减少面对面就诊的需要（63%）。临床医生最常监测的症状是（93%）、血氧饱和度（74%）和体力活动（72%）。被认为最有效的设备是肺活量计（43%）和脉搏血氧仪（33%）。临床医生参与远程医疗的主要障碍是组织结构（80%）、技术挑战（63%）以及缺乏时间和/或工作量（63%）。临床医生认为患者参与远程医疗的障碍可能包括缺乏意识（76%）、缺乏使用智能手机的知识（60%）以及对远程医疗缺乏信心（56%）。
完成这项调查并使用远程医疗监测患者的ILD 临床医生（n=81）支持其临床效用。我们的研究结果强调了需要对远程医疗进行强有力的研究，以作为ILD 中提供具有成本效益的医疗保健服务的一种模式，并突出了评估患者观点以提高ILD 患者远程医疗效用的必要性。
