BACKGROUND: Forced spirometry is essential for diagnosing respiratory diseases and is widely used across levels of care. However, several studies have shown that spirometry quality in primary care is not ideal, with risks of misdiagnosis. Our objective was to assess the feasibility and performance of a telemedicine-based training and quality assurance program for forced spirometry in primary care. MATERIALS AND METHODS: The two phases included (1) a 9-month pilot study involving 15 centers, in which spirometry tests were assessed by the Basque Office for Health Technology Assessment, and (2) the introduction of the program to all centers in the Public Basque Health Service. Technicians first received 4 h of training, and, subsequently, they sent all tests to the reference laboratory using the program. Quality assessment was performed in accordance with clinical guidelines (A and B, good; C-F, poor). RESULTS: In the first phase, 1,894 spirometry tests were assessed, showing an improvement in quality: acceptable quality tests increased from 57% at the beginning to 78% after 6 months and 83% after 9 months (p<0.001). In the second phase, 7,200 spirometry tests were assessed after the inclusion of 36 additional centers, maintaining the positive trend (61%, 87%, and 84% at the same time points; p<0.001). CONCLUSIONS: (1) The quality of spirometry tests improved in all centers. (2) The program provides a tool for transferring data that allows monitoring of its quality and training of technicians who perform the tests. (3) This approach is useful for improving spirometry quality in the routine practice of a public health system.
BACKGROUND: Forced spirometry is essential for diagnosing respiratory diseases and is widely used across levels of care. However, several studies have shown that spirometry quality in primary care is not ideal, with risks of misdiagnosis. Our objective was to assess the feasibility and performance of a telemedicine-based training and quality assurance program for forced spirometry in primary care. MATERIALS AND METHODS: The two phases included (1) a 9-month pilot study involving 15 centers, in which spirometry tests were assessed by the Basque Office for Health Technology Assessment, and (2) the introduction of the program to all centers in the Public Basque Health Service. Technicians first received 4 h of training, and, subsequently, they sent all tests to the reference laboratory using the program. Quality assessment was performed in accordance with clinical guidelines (A and B, good; C-F, poor). RESULTS: In the first phase, 1,894 spirometry tests were assessed, showing an improvement in quality: acceptable quality tests increased from 57% at the beginning to 78% after 6 months and 83% after 9 months (p<0.001). In the second phase, 7,200 spirometry tests were assessed after the inclusion of 36 additional centers, maintaining the positive trend (61%, 87%, and 84% at the same time points; p<0.001). CONCLUSIONS: (1) The quality of spirometry tests improved in all centers. (2) The program provides a tool for transferring data that allows monitoring of its quality and training of technicians who perform the tests. (3) This approach is useful for improving spirometry quality in the routine practice of a public health system.
Authors: Carme Hernández; Albert Alonso; Judith Garcia-Aymerich; Anders Grimsmo; Theodore Vontetsianos; Francesc García Cuyàs; Anna Garcia Altes; Ioannis Vogiatzis; Helge Garåsen; Laura Pellise; Leendert Wienhofen; Isaac Cano; Montserrat Meya; Montserrat Moharra; Joan Ignasi Martinez; Juan Escarrabill; Josep Roca Journal: Int J Integr Care Date: 2015-03-30 Impact factor: 5.120
Authors: Brian L Graham; Irene Steenbruggen; Martin R Miller; Igor Z Barjaktarevic; Brendan G Cooper; Graham L Hall; Teal S Hallstrand; David A Kaminsky; Kevin McCarthy; Meredith C McCormack; Cristine E Oropez; Margaret Rosenfeld; Sanja Stanojevic; Maureen P Swanney; Bruce R Thompson Journal: Am J Respir Crit Care Med Date: 2019-10-15 Impact factor: 21.405
Authors: Meredith C McCormack; Rebecca Bascom; Michael Brandt; Felip Burgos; Sam Butler; Christopher Caggiano; Anne E F Dimmock; Adrian Fineberg; Jeffrey Goldstein; Francisco C Guzman; Cara N Halldin; J D Johnson; Gwendolyn S Kerby; Jerry A Krishnan; Laura Kurth; Gareth Morgan; Richard A Mularski; Cara B Pasquale; Julie Ryu; Tom Sinclair; Nadia F Stachowicz; Ann Taite; Jacob Tilles; Jennifer R Truta; David N Weissman; Tianshi David Wu; Barbara P Yawn; M Bradley Drummond Journal: Ann Am Thorac Soc Date: 2021-01
Authors: Claudia Vargas; Felip Burgos; Isaac Cano; Isabel Blanco; Pere Caminal; Joan Escarrabill; Carles Gallego; Ma Antonia Llauger; Felip Miralles; Oscar Solans; Montserrat Vallverdú; Filip Velickovski; Josep Roca Journal: NPJ Prim Care Respir Med Date: 2016-06-02 Impact factor: 2.871