Achievement of high-quality home spirometry in patients with asthma: The NuvoAir platform

INTRODUCTION Self-monitoring has a recognized place in achieving asthma control. Traditionally, patients record symptoms and peak flow measurement in a paper diary, which they use to adjust therapy in accordance with written asthma plans. Telemonitoring augments disease management by facilitating patients to record their level of asthma control electronically, supporting remote physician consultations. This study evaluated the quality of home-based spirometry in asthma using the NuvoAir platform (NuvoAir U. S inc, Boston, M.A., U.S.A.), which consists of a smartphone application, Bluetooth spirometer (AirNext), and physician portal. METHODS Consecutive adults with difficult-to-treat or severe asthma were trained on the AirNext, and were asked to perform home spirometry daily for the first month and then weekly or on symptom worsening. These analyses used data from patients who performed their first unsupervised spirometry within 30 days of their supervised. The grading of the quality of spirometry sessions was based on the American Thoracic Society Technical Statement. RESULTS A total of 10 patients with asthma (four uncontrolled asthma; six partly controlled [GINA 2018]) were included in this study, 9 (90%) female, mean age 42.0 +/- 10.7 years, with FEV1 69.6 +/- 26.2% (range: 27.3-101.0) predicted at the supervised session. Patients performed 1235 unsupervised sessions over 181.5 +/- 153.9 days (maximum 382 days), 877 (71.0%) of which were acceptable quality, the majority of these (556) being Grade A. CONCLUSIONS Overall our data show that unsupervised home spirometry can provide high quality results. More studies are needed to assess home unsupervised spirometry in larger populations and determine whether it may lead to improved patient outcomes.