However, there are some drawbacks to this style of attention. Getting to a specialized facility can be exhausting and lead to loss of school and work. In addition, others with cystic fibrosis are at risk of cross-infection. The desire to mix patients poses situations of logistical demand and reduces the number of people who can be treated in a given time.
For these reasons, the answers of choice have been in recent years, adding telemedicine and video consultations, the provision of home tracking devices (such as spirometers to measure lung function), the use of smart devices to motivate and measure adherence to treatment, and studies on diagnosis of infections at the point of attention. In general, these approaches are just beginning to advance beyond studies or the pilot stage.
But those approaches came to the fore in early 2020, when the COVID-19 pandemic hit physical care systems and extensive care amenities in many countries. People with cystic fibrosis were among those known as vulnerable to COVID-19 and were asked to take more precautions. In the UK, this meant staying at home, a procedure called armor. Many hospitals have moved their staff to the growing amount of COVID-19 income and, for some time, closed the clinical regimen work, adding outpatient services, to restrict the threat of infection.
This has led to an immediate replacement in the way care is provided, at a rate rarely seen in the UK’s National Health Service. The appointments were made by phone or video that face to face. Systematic monitoring devices for respiratory and lung infections serve as sent to patients’ homes.
Although maximum studies without COVID have been discontinued, some drug trials have been allowed to continue, with “virtual” visits to facilitate access to treatments that had not yet been prescribed. Clinical teams, patients, families and pharmaceutical corporations temporarily adapted to the emergency situation.
It is tempting to use this evidence of adaptability as an argument for immediate and permanent replacement in the way we care for others with cystic fibrosis. However, problems remain and, in my opinion, need to be addressed.
What can be missing from such a replacement and what would physical health look like? For example, the accuracy of home lung service as measurements has been underestimated. Clinical lung measurements serve as a guide through a technician, trained to identify an unacceptable quality result and inspire the patient to review again. How does the house test the quality of measurements without supervision? There are several gadgets available; Do they produce equivalent and reproducible results?
What about fitness and intellectual well-being? Cystic fibrosis is linked to higher rates of depression and anxiety. The quality-of-life benefits of reducing hospital visits might seem obvious, but outside the context of a pandemic, will other people miss the non-public facets of their care? This may also be the case for specialist nurses and psychologists.
Is the generation widely available and affordable? It is probably naive to think that this technique will save money, and that infrastructure, data generation, and knowledge governance will require an assessment of the additional functions that are desired to safely implement any changes. The composition of the groups would possibly also like to change, and implementation strategies will in fact be. In addition, there is already a significant gap in physical fitness outcomes among patients with the largest and least economical resources. Creating reliance on access to smartphones or high-speed Internet can also expand this hole.
Can remotely collected knowledge for clinical trials meet the strict criteria required by regulators? Once the pressures of the existing scenario have eased, it is imperative that this factor be fully addressed, for example, as a component of an experiment introduced through the UK National Health Research Institute.
Nature 583, S15 (2020)
This article is part of Nature Outlook: Cystic Fibrosis, an independent editorial supplement produced with third-party component money. About this content.
Article 12 AO 20
News and opinions 12 AO 20
Article 12 AO 20
Editorial 12 AO 20
WorldView 20
Correspondence AO 20
News Feature 27 MAY 20
News thirteen May 20
SEA Views 20