{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,8,26]],"date-time":"2026-08-26T19:26:22Z","timestamp":1787772382350,"version":"build-2784847793"},"reference-count":21,"publisher":"JMIR Publications Inc.","content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["JMIR Form Res"],"abstract":"Abstract<\/jats:title>\n \n Background<\/jats:title>\n Home spirometry has been widely adopted in the delivery of cystic fibrosis (CF) care. While existing literature largely supports its feasibility and positive outcomes, behavior around home disease monitoring remains poorly understood. Inaccurate assumptions about home spirometry behavior may affect resource prioritization and influence clinical decisions and follow-up.<\/jats:p>\n <\/jats:sec>\n \n Objective<\/jats:title>\n This study aimed to evaluate health care professionals\u2019 (HCPs\u2019) ability to estimate home spirometry use among people with CF and compare these estimates with actual recorded data.<\/jats:p>\n <\/jats:sec>\n \n Methods<\/jats:title>\n Home spirometry data from 48 people with CF attending a large adult CF center in the United Kingdom were obtained from the NuvoAir platform for the period from January to December 2024. The home spirometry data were sampled to represent 3 predefined use categories: infrequent, expected, and highly frequent users. A paper-based survey was distributed to HCPs with experience using home spirometry within the CF service, including physicians, CF specialist nurses, and physiotherapists, with survey dissemination and data collection completed in January 2025. Participants rated their familiarity with each person with CF and estimated their spirometry use both categorically (infrequent, expected, or highly frequent user) and numerically as an open-ended response. CF experience was defined as the number of years worked within the CF service. Estimation accuracy was evaluated using mean bias and mean absolute error (MAE).<\/jats:p>\n <\/jats:sec>\n \n Results<\/jats:title>\n \n Of the 29 HCPs invited to participate, 28 (96.6%) responded to the survey, including 10 (35.7%) physicians, 6 (21.4%) nurses, and 12 (42.9%) physiotherapists. There were 790 completed categorical estimates and 794 numerical estimates. The mean CF experience was 15.7 (SD 8.2) years. Across all roles, HCPs systematically underestimated home spirometry use (mean bias \u22124.9, SD 8.9; MAE 6.32, SD 8.1). No substantial differences in estimation accuracy were observed based on professional role, reported familiarity, or CF experience. Estimation accuracy declined with increasing actual spirometry use, with a strong negative Spearman rank correlation (\u03c1=\u22120.88;\n P<\/jats:italic>\n <.001). HCPs tended to cluster their estimates within a narrow range, with a median of 4 (IQR 1-5) spirometry sessions per year.\n <\/jats:p>\n <\/jats:sec>\n \n Conclusions<\/jats:title>\n This study suggests that clinical perception by HCPs alone may not accurately reflect real-world engagement with home spirometry in people with CF. As CF care increasingly incorporates remote monitoring and virtual consultations, understanding actual patient engagement becomes increasingly important. Further qualitative and mixed methods research is needed to better understand the factors influencing home spirometry use and how different patterns of engagement can be effectively identified and supported.<\/jats:p>\n <\/jats:sec>","DOI":"10.2196\/93545","type":"journal-article","created":{"date-parts":[[2026,7,13]],"date-time":"2026-07-13T16:45:06Z","timestamp":1783961106000},"page":"e93545-e93545","source":"Crossref","is-referenced-by-count":0,"title":["Health Care Professionals\u2019 Estimation of Home Spirometry Use Among People With Cystic Fibrosis: Cross-Sectional Study"],"prefix":"10.2196","volume":"10","author":[{"ORCID":"https:\/\/orcid.org\/0000-0001-9270-1127","authenticated-orcid":false,"given":"Aqeem","family":"Azam","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-3232-1055","authenticated-orcid":false,"given":"Andrew M","family":"Jones","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-5259-4918","authenticated-orcid":false,"given":"Rowland J","family":"Bright-Thomas","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-1828-0058","authenticated-orcid":false,"given":"Alex","family":"Horsley","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-6326-4431","authenticated-orcid":false,"given":"Peter J","family":"Barry","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1010","published-online":{"date-parts":[[2026,8,26]]},"reference":[{"key":"R1","unstructured":"2023 Patient registry annual data report. Cystic Fibrosis Foundation; 2023. URL: https:\/\/www.cff.org\/medical-professionals\/patient-registry [Accessed 19-08-2026]"},{"key":"R2","unstructured":"Roseby C Ellis K Edwards R et al. Cystic fibrosis standards of care, Australia 2025. Cystic Fibrosis Australia; 2025. URL: https:\/\/www.cysticfibrosis.org.au\/wp-content\/uploads\/2025\/10\/Framework-for-CF-Care-Publish.pdf [Accessed 19-08-2026]"},{"key":"R3","unstructured":"UK Patient Reported Experience Measures (PREMs) survey: adult CF services report. Cystic Fibrosis Trust; 2024. URL: https:\/\/www.cysticfibrosis.org.uk\/sites\/default\/files\/2024-10\/PREMs_Adult_Report_UK_2023-24_FINAL.pdf [Accessed 19-08-2026]"},{"issue":"1","key":"R4","doi-asserted-by":"publisher","first-page":"12","DOI":"10.1016\/j.jcf.2023.12.002","article-title":"Standards for the care of people with cystic fibrosis; establishing and maintaining health","volume":"23","author":"Southern","journal-title":"J Cyst Fibros"},{"key":"R5","unstructured":"Standards for the clinical care of children and adults with cystic fibrosis in the UK (2024). Cystic Fibrosis Trust; 2024. URL: https:\/\/www.respiratoryfutures.org.uk\/health-condition-resources\/cystic-fibrosis\/standards-for-the-clinical-care-of-children-and-adults-with-cystic-fibrosis-in-the-uk-2024\/ [Accessed 19-08-2026]"},{"key":"R6","doi-asserted-by":"publisher","DOI":"10.2196\/54942","article-title":"Potential, pitfalls, and future directions for remote monitoring of chronic respiratory diseases: multicenter mixed methods study in routine cystic fibrosis care","volume":"26","author":"Oppelaar","journal-title":"J Med Internet Res"},{"issue":"6","key":"R7","doi-asserted-by":"publisher","first-page":"1055","DOI":"10.1016\/j.jcf.2024.08.007","article-title":"Cystic fibrosis foundation position paper: redefining the CF care model","volume":"23","author":"Goetz","journal-title":"J Cyst Fibros"},{"key":"R8","doi-asserted-by":"publisher","DOI":"10.1177\/17534666211070133","article-title":"A prospective randomised controlled mixed-methods pilot study of home monitoring in adults with cystic fibrosis","volume":"16","author":"Nash","journal-title":"Ther Adv Respir Dis"},{"issue":"1","key":"R9","doi-asserted-by":"publisher","first-page":"84","DOI":"10.1016\/j.jcf.2021.10.012","article-title":"Quality of home spirometry performance amongst adults with cystic fibrosis","volume":"21","author":"Bell","journal-title":"J Cyst Fibros"},{"issue":"4","key":"R10","doi-asserted-by":"publisher","first-page":"A5783","DOI":"10.1016\/j.chest.2023.07.3727","article-title":"Comparison study of unsupervised remote and supervised clinic spirometry measurements in a clinical trial setting","volume":"164","author":"Fuller","journal-title":"Chest"},{"key":"R11","doi-asserted-by":"publisher","DOI":"10.2196\/60892","article-title":"Accuracy, reproducibility, and responsiveness to treatment of home spirometry in cystic fibrosis: multicenter, retrospective, observational study","volume":"26","author":"Oppelaar","journal-title":"J Med Internet Res"},{"issue":"11","key":"R12","doi-asserted-by":"publisher","first-page":"2967","DOI":"10.1002\/ppul.27166","article-title":"Telemedicine and home spirometry in cystic fibrosis: a prospective multicenter study","volume":"59","author":"Medbo","journal-title":"Pediatr Pulmonol"},{"issue":"4","key":"R13","doi-asserted-by":"publisher","first-page":"431","DOI":"10.1002\/ppul.23950","article-title":"Impact of home spirometry on medication adherence among adolescents with cystic fibrosis","volume":"53","author":"Shakkottai","journal-title":"Pediatr Pulmonol"},{"key":"R14","doi-asserted-by":"publisher","DOI":"10.2196\/60689","article-title":"The long-term uptake of home spirometry in regular cystic fibrosis care: retrospective multicenter observational study","volume":"27","author":"Bertram","journal-title":"J Med Internet Res"},{"issue":"6","key":"R15","doi-asserted-by":"publisher","DOI":"10.1002\/ppul.71691","article-title":"Clinical use of home spirometry in children with cystic fibrosis","volume":"61","author":"Tan","journal-title":"Pediatr Pulmonol"},{"key":"R16","doi-asserted-by":"publisher","DOI":"10.3389\/fped.2023.1111088","article-title":"Adherence, reliability, and variability of home spirometry telemonitoring in cystic fibrosis","volume":"11","author":"Beaufils","journal-title":"Front Pediatr"},{"issue":"12","key":"R17","doi-asserted-by":"publisher","first-page":"3129","DOI":"10.1002\/ppul.26147","article-title":"Real-world feasibility of short-term, unsupervised home spirometry in CF","volume":"57","author":"Davis","journal-title":"Pediatr Pulmonol"},{"issue":"8","key":"R18","doi-asserted-by":"publisher","first-page":"e70","DOI":"10.1164\/rccm.201908-1590ST","article-title":"Standardization of spirometry 2019 update. An official American Thoracic Society and European Respiratory Society technical statement","volume":"200","author":"Graham","journal-title":"Am J Respir Crit Care Med"},{"issue":"2","key":"R19","doi-asserted-by":"publisher","first-page":"425","DOI":"10.1378\/chest.09-3074","article-title":"Accurate assessment of adherence: self-report and clinician report vs electronic monitoring of nebulizers","volume":"140","author":"Daniels","journal-title":"Chest"},{"key":"R20","doi-asserted-by":"publisher","DOI":"10.1016\/S1569-1993(24)00228-5","article-title":"EPS2.08 Anxiety and spirometry: prevalence, patient experience, and how providers can help","volume":"23","author":"Bruschwein","journal-title":"J Cyst Fibros"},{"issue":"2","key":"R21","doi-asserted-by":"publisher","first-page":"321","DOI":"10.1016\/j.jcf.2023.05.011","article-title":"Quantifying variation in home spirometry in people with cystic fibrosis during baseline health, and associations with clinical outcomes","volume":"23","author":"Thornton","journal-title":"J Cyst Fibros"}],"container-title":["JMIR Formative Research"],"original-title":[],"language":"en","deposited":{"date-parts":[[2026,8,26]],"date-time":"2026-08-26T18:42:23Z","timestamp":1787769743000},"score":1,"resource":{"primary":{"URL":"https:\/\/formative.jmir.org\/2026\/1\/e93545"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2026,8,26]]},"references-count":21,"URL":"https:\/\/doi.org\/10.2196\/93545","relation":{},"ISSN":["2561-326X"],"issn-type":[{"value":"2561-326X","type":"electronic"}],"subject":[],"published":{"date-parts":[[2026,8,26]]},"article-number":"v10i1e93545"}}