Home monitoring for patients with lung diseases during COVID-19

A new home monitoring service provided by Oxford University Hospitals has benefitted more than 160 extremely vulnerable patients with interstitial lung diseases (ILD).

Patients with ILD, an umbrella term for more than 200 chronic lung disorders, can experience progressive lung scarring and require regular care, and are at high risk of COVID-19.

As a result, the Trust's Interstitial Lung Disease Service launched a new service in September 2020 allowing patients to carry out lung function testing (spirometry) in their own home. Such monitoring can detect progression in their lung disease or response to treatment, without the need to attend hospital.

Spirometers can inform how well the lungs are working by accurately measuring the largest breath a person can take and how quickly they can force that breath out. These spirometers have been sent to homes across Oxfordshire and the surrounding counties, allowing patients to carry out their test at home and email results in.

Dr Rachel Hoyles, Lead Interstitial Lung Diseases consultant at Oxford University Hospitals, said: "Home spirometry allows patients to monitor their lung condition without leaving their home, which is especially important for a specialist ILD centre such as ours where patients travel from across Oxfordshire and the surrounding counties.

"The results which patients email to us allow our specialist team to detect any changes early, rapidly follow this up with video review and treatment if required. In its first few months, this service has already made a clear positive impact on patient care."

'Totally exemplary'

The home spirometry service has supported more than 160 patients so far, including Simone Hunter from Childrey, near Wantage.

Simone has received care at both the Churchill and John Radcliffe hospitals in Oxford for the last eight years to treat her chronic sarcoidosis, a rare inflammatory condition that can lead to progressing scarring in the organs of the body.

It means Simone has breathing problems, chronic pain, and fatigue, among other issues that restricts her from working.

Before the pandemic, her care required multiple hospital visits. This changed due to COVID-19 and all consultant contact has been via telephone or video call.

Simone received her spirometer to help with her lung function testing in November 2020.

She said: "The Interstitial Lung Disease Service has been totally exemplary. The team has somehow managed to continue high levels of care during such a challenging time.

"In this past year, staff have been even more thorough and gone the extra mile to provide even better care while keeping us safe. I wanted to say a huge thank you to the staff involved as I am so grateful.

"The spirometer has been so useful as it has meant we can keep track of my lung function without leaving the house or putting anyone at risk during the pandemic. The test is much easier doing it at home."

The ILD service links with the Trust's strategic themes of delivering care close to home and being digital by default.

Sam Foster, Chief Nursing Officer at Oxford University Hospitals, said: "Since the start of the COVID-19 pandemic, our staff have been working so hard to adapt so we can continue to provide our services as safely as possible.

"Distributing spirometers is an example of this. We know that some people in higher risk groups are anxious about travelling to hospital, and this initiative means they can be monitored from the comfort of their own home.

"The Interstitial Lung Disease Service has done fantastically well to remove the anxiety of a hospital visit at this time for so many of our patients with this patient-centred approach."

Pictured: Dr Rachel Hoyles, Lead Interstitial Lung Diseases Consultant at OUH, and the team