Telemedicine enhances quality of forced spirometry in primary care.

Eur Respir J. 2011 Nov 10. Burgos F, Disdier C, Lopez de Santamaria E, Galdiz B, Roger N, Rivera ML, Hervas R, Duran-Tauleria E, Garcia-Aymerich J, Roca J; on behalf of e-Spir@p group. Hospital Clínic. CIBER de Enfermedades Respiratorias (CibeRes), Universitat de Barcelona, Barcelona.

Forced spirometry is pivotal for diagnosis and management of respiratory diseases, but its use in primary care is suboptimal To assess a web-based application aiming at fostering high quality spirometry in primary care. Randomized controlled trial with 12 intervention primary care units (PCi) and 6 control units (PCc) studied during 12 m All 34 naïve nurses (PCi and PCc) received identical training. The PCi units had access to educational material and remote expert support. Quality of spirometries and usability of the web application were assessed.We included 4.581 patients (3.383 PCi and 1.198 PCc). At baseline, quality was similar (PCi, 71% and PCc, 67% high quality tests). Through the study, PCi showed higher percentage (71.5%) of high quality tests than PCc (59.5%) (p<0.0001). PCi had 73% more chances of high quality performance than PCc. The web application was better to assess quality of testing than the automatic feed-back provided by the spirometer. Professional's satisfaction and usability were high.

The web-based remote support to primary care by specialists generated a sustained positive impact on quality of testing. The study expands the potential of primary care for diagnosis and management of patients with pulmonary diseases.

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