Abiding by the extensive treatment regimen for cystic fibrosis (CF) can be especially challenging for pediatric patients. A new study found that frequent monitoring of pulmonary function tests (PFTs) and medication reminders can help pediatric CF patients better meet their daily medication and vitamin requirements. The study also suggests that a personal home spirometer that provides medication reminders can help improve treatment adherence.
The study is titled, “The Use of Home Spirometry in Pediatric Cystic Fibrosis Patients,” and was published in the journal Global Pediatric Health.
Adherence, which measures the degree to which a patient correctly follows medical advice, is generally low for teenagers and young adults with CF. The refill rate of CF medication prescriptions is only 46% for pancreatic enzymes, 60% for multivitamins, and 65% for mucus-thinning mucolytic agents, according to the study.
Low adherence rates have been linked to a greater decrease in lung function in CF patients, particularly adolescents. Scientists, physicians, and pharmaceutical companies have been trying to find methods to increase adherence in this particular patient population.
Researchers at the University of Michigan conducted a survey of 40 pediatric CF patients to better understand their opinions of various adherence strategies that could be implemented. The survey was conducted in-person during regular clinical visits, during hospitalization, and via telephone over four months.
Participants reported that the two most common barriers to adhering to their medication regimen were forgetfulness and lack of time. They also reported that the top motivation for adherence was avoiding hospitalization, followed by improving lung function.
Asked for ideas to help more closely adhere to treatment, patients suggested more frequent PFTs and medication reminders. PFTs are tests that measure how well the lungs work and are generally done by physicians using a medical device called a spirometer.
Researchers developed a personal home spirometer that also provides medication reminders to test whether this method would increase adherence. For this part of the study, researchers recruited five patients, ages 10 to 14, who conducted the survey. Three of these patients were asked to use the Spiro PD, a Food and Drug Administration-approved personal home spirometer, while the other two followed a normal routine.
During the three months of the study, patients using the device improved their FEV1 (Forced Expiratory Volume 1) percentage, a parameter used to determine lung function. Patients using this device also improved adherence.
While the personal home spirometer appears promising, one of the study’s weaknesses, according to its authors, is its small enrollment size. This factor limited researchers’ ability to reach definitive conclusions about the device. The team currently is conducting a larger study to examine the personal home spirometer’s effects on CF patient adherence.