Acceptability of Remote Monitoring in Connective Tissue Disease-related Interstitial Lung Disease

Abstract Rationale: As with other forms of interstitial lung disease (ILD), patients with connective tissue disease-associated ILD (CTD-ILD) require comprehensive, longitudinal monitoring of symptoms, physiological parameters, and imaging to accurately assess disease progression, evaluate therapeutic response, and enable timely detection of changes in disease severity.Remote monitoring using patient-recorded spirometry and Patient-Reported Outcome Measures (PROMs) offers a way to closely track changes in clinical status for individuals with ILD, allowing for timely interventions and better support during in-person appointments. Although studies have demonstrated concordance between remote and in-hospital spirometry measurements, remote monitoring has not yet been widely integrated into routine clinical practice. This research study was conducted to learn more about CTD-ILD patient and clinician adherence and acceptance of remote monitoring and to assess readability and acceptance of an electronic version of the Living with Pulmonary Fibrosis questionnaire (L-PF) recorded on a mobile device-based remote monitoring platform. Methods: Prospective, observational study of CTD-ILD patients (diagnosis according to American College of Rheumatology criteria). Patients were randomised to record home spirometry between 1 and 4 times per week for 90 days using a digital health application & Bluetooth-linked spirometer and complete the L-PF questionnaire weekly in the application. The data was available for clinician review in real time and monitored bi-weekly or monthly by their clinicians. Feasibility was assessed using patient adherence to prescribed measurements and patients’ perceptions of utility and acceptability of the platform via questionnaire. Results: 20 CTD-ILD patients consented and 15/20 provided ≥1 spirometry reading and were included in the analysis of adherence. 5/10 female; age 61 years (± 13.2). Adherence is displayed in the table below. Conclusions: This study found that CTD-ILD patients assigned to once or twice-weekly spirometry showed the highest adherence rates, with the 2x/week group achieving 76.92% adherence to expected readings and recording at least one reading 87.69% of weeks. In contrast, adherence declined in the 3x/week and 4x/week groups. These findings suggest that lower-frequency monitoring may better support patient adherence in remote ILD management.