The use of a mobile spirometry with a feedback quality assessment in primary care setting - A nationwide cross-sectional feasibility study

Objectives: Mobile phone-linked portable spirometers are light-weight, easy to use and low cost, with new software to facilitate data collection. In this study we investigated the feasibility of the AioCare (R) mobile spirometry in primary care. Methods: In this nationwide, cross-sectional study, AioCare (R) spirometers (HealthUp, Poland) were distributed among primary healthcare centres across Poland. Operators (primary care professionals) received a 2-h training session, after which spirometry was performed in patients attending routine visits with respiratory symptoms or risk factors for obstructive airway diseases. Spirometry was considered technically correct when at least three manoeuvres met ERS/ATS acceptability and repeatability criteria. The most common spirometry errors were assessed and stepwise logistic regression was applied to identify factors associated with technically correct spirometry. Airway obstruction was defined as FEV1/FVC below the lower limit of normal. A restrictive pattern was defined as FVC below the lower limit of normal. Results: Between 1 September 2018 and 1 September 2019, 10,936 spirometry examinations were performed in 9855 patients by 673 operators. 5347 (49%) spirometry examinations met both acceptability and repeatability criteria. The most common error was plateau error (17.7%). Operator age >40 years (OR 1.49, 95% CI 1.35-1.64) and repetition of the examination at the same visit (OR 1.90, 95% CI 1.66-2.16) increased the likelihood of a technically correct examination. Airway obstruction was found in 17% of correctly performed spirometry examinations. Conclusions: Our nationwide study suggests that use of the AioCare (R) mobile spirometer in primary care could be feasible. More intensive and continual training should be implemented to improve the quality of spirometry examinations.

Automated summary

This study investigated the feasibility of using the AioCare(R) mobile spirometer in primary care, finding that operator age and repetition of the examination were associated with technically correct examinations. Airway obstruction was found in a significant portion of correctly performed spirometry examinations.