Remote Patient Monitoring for Managing Interstitial Lung Disease: A Mixed-Methods Process Evaluation

Area of Science:

• Pulmonary Medicine
• Health Services Research
• Implementation Science

Background:

• Hybrid health care models combine in-person and telehealth for interstitial lung disease (ILD) care.
• Telehealth visits present limitations in assessing ILD activity and progression.
• Remote patient monitoring (RPM) offers a solution for evaluating ILD trajectories, but its adoption in the US remains low.

Purpose of the Study:

• To identify patient-level facilitators and barriers to implementing RPM in routine ILD care.
• To explore patient experiences with RPM devices and data in ILD management.

Main Methods:

• A parallel convergent mixed-methods design was employed.
• Weekly RPM data (spirometry, pulse oximetry) were collected from newly diagnosed ILD patients.
• Surveys and qualitative interviews were used to gather patient-level data, analyzed thematically and integrated via triangulation.

Main Results:

• Sixty participants (median age 74) with newly diagnosed ILD were included; 50% had idiopathic pulmonary fibrosis.
• High adherence (90%) to weekly RPM device use was observed, with participants viewing RPM as important (90%) and sustainable (87%).
• Key barriers identified included challenges with spirometry technique, result communication, and interpretation.

Conclusions:

• RPM is a feasible, valuable, and sustainable component of ILD care.
• Addressing patient-level barriers through supervised setup, enhanced communication, and improved education is crucial for successful RPM implementation.
• Overcoming these barriers can increase RPM adoption, potentially improving patient engagement in ILD care.