Comparing Approaches to Teaching Patients How to Use an App-Based Home Spirometer: Randomized Controlled Trial

Area of Science:

• Pulmonary Medicine
• Digital Health
• Medical Technology

Background:

• Bluetooth-enabled, app-based home spirometry is validated for respiratory disease diagnosis and monitoring.
• Remote teaching methods (virtual, self-directed) offer scalable and safe delivery of home spirometry diagnostics.
• The optimal teaching method for home spirometry remains undetermined.

Purpose of the Study:

• To evaluate the validity of virtual and self-directed teaching for home spirometry deployment.
• To compare remote teaching methods against traditional face-to-face instruction for outpatient lung physiology testing.

Main Methods:

• A randomized controlled trial (REACH-SPIRO) involving 106 adults referred for spirometry.
• Participants were randomized to face-to-face, virtual, or self-directed training for Bluetooth app-based spirometry.
• Comparison of home spirometry (Spirobank Smart) readings with hospital standards (Vyaire Medical) using Bland-Altman analysis; patient feedback collected.

Main Results:

• No significant difference in forced expiratory volume in 1 second (FEV1) or forced vital capacity (FVC) measurements between the three training groups.
• Bland-Altman analysis showed comparable agreement between home and hospital measurements across all modalities.
• Patient feedback was favorable for all methods, with a slight preference for face-to-face and virtual teaching.

Conclusions:

• Virtual or self-directed teaching of home spirometry is as effective as face-to-face instruction.
• These remote methods support expanded access to spirometry for underserved and vulnerable populations.
• Home spirometry, taught remotely, is a viable option for monitoring respiratory conditions.