Home-based spirometry telemonitoring after allogeneic hematopoietic cell transplantation: a mixed methods evaluation of acceptability and usability (Preprint)

BACKGROUND Home-based spirometry (HS) allows for early detection of lung complications in allogeneic hematopoietic cell transplant (A-HCT) recipients. Although usability and acceptability oWe designed a longitudinal, mixed-methods study to understand the usability and acceptability of HS among A-HCT recipients.f HS is critical for adherence, patient-reported outcomes of HS use remain poorly understood in this setting. OBJECTIVE We designed a longitudinal, mixed-methods study to understand the usability and acceptability of HS among A-HCT recipients. METHODS Study participants performed HS using a Bluetooth-capable spirometer that transmitted spirometry data to the study team in real-time. In addition, participants completed usability questionnaires and in-depth interviews, and reported their experience with HS. Analysis of interview data was guided by the constructs of performance expectancy, effort expectancy, and social influence from the Unified Theory of Acceptance and Use of Technology model. RESULTS A-HCT recipients found HS to be highly acceptable despite modest technological barriers. On average, participants believed that the HS was helpful in managing symptoms related to A-HCT (scores ranging from 2.22 – 2.68 on a scale of 0-4) and for early detection of health related problems (score range: 2.88 – 3.12). Participants viewed HS favorably and were generally supportive of continued use. No significant barriers to implementation were identified from the patient’s perspective. Age and gender were not associated with patient perception of HS. CONCLUSIONS Study participants found HS acceptable and easy to use. Some modifiable technical barriers to performing HS were identified, but wider implementation for pulmonary screening is feasible from the patient’s perspective.