BlueCross BlueShield of Tennessee Medical Policy Manual

Home Spirometry

DESCRIPTION

Home spirometry devices allow for the monitoring of pulmonary function in the home. Battery-operated spirometers permit regular daily measurement of pulmonary function, typically forced expiratory volume in 1 second (FEV-1) and forced vital capacity (FVC). Home spirometry may also be referred to as ambulatory spirometry.

The primary proposed use is to aid in the early diagnosis of infection and rejection in lung transplant recipients. These devices have also been suggested for use in monitoring pulmonary function in chronic obstructive pulmonary disease (COPD), Cystic Fibrosis and asthma.

POLICY

IMPORTANT REMINDERS

ADDITIONAL INFORMATION

There is a lack of high-quality trials to determine if home monitoring of pulmonary function results improved health outcomes. Therefore this technology remains investigational.

SOURCES

American College of Physicians. (2011). Diagnosis and management of stable chronic obstructive pulmonary disease: a clinical practice guideline update from the American College of Physicians, American College of Chest Physicians, American Thoracic Society, and European Respiratory Society. Retrieved June 2, 2016 from http://annals.org.

De Wall, C., Sabine, D., Gregor, W., Mark, G., Axel, H., Thomas, F., et al. (2014). Home spirometry as early detector of azithromycin refractory bronchiolitis obliterans syndrome in lung transplant recipients. Respiratory Medicine, 108, 405-412. (Level 4 evidence)

Deschildre, A., Bèghin, L., Salleron, J., Iliescu, C., Thumerelle, C., Santos, C., et al. (2012). Home telemonitoring (forced expiratory volume in 1 s) in children with severe asthma does not reduce exacerbations. European Respiratory Journal, 39, 290-296. (Level 2 evidence)

Fadaizadeh, L., Najafizadeh, K., Shajareh, E., Shafaghi, S., Hosseini, M., & Heydari, G. (2016). Home spirometry: assessment of patient compliance and satisfaction and its impact on early diagnosis of pulmonary symptoms in post-lung transplantation patients. Journal of Telemedicine and Telecare, 22 (2) 127-131. Abstract retrieved June 2, 2016 from PubMed database.

Finkelstein, S., Lindgren, B., Robiner, W., Lindquist, R., Hertz, M., Carlin, B., et al. (2013). A randomized controlled trial comparing health and quality of life of lung transplant recipients following nurse and computer-based triage utilizing home spirometry monitoring. Telemedicine and e-Health, 19 (12), 897-903. (Level 2 evidence)

Lechtzin, N., West, N., Allgood, S., Wilhelm, E., Khan, U., Mayer-Hamblett, N., et al. (2013). Rationale and design of a randomized trial of home electronic symptom and lung function monitoring to detect cystic fibrosis pulmonary exacerbations: the early intervention in cystic fibrosis exacerbation (eICE) trial. Contemporary Clinical Trials, 36 (2), 460-469. Abstract retrieved June 2, 2016 from PubMed database.

Murgia, F., Bianciardi, F., Solvoll, T., Tagliente, I., Bella, F., Carestia, A., & Bella, S., (2015). Telemedicine home program in patients with cystic fibrosis: results after 10 years. La Clinica Terapeutica, 166 (69), e384-e388. Abstract retrieved June 2, 2016 from PubMed database.

National Government Services, Inc. (2017, March). Local coverage determination (LCD) for non-covered services (L33629). Retrieved March 27, 2015 from https://www.cms.gov.

Robson, K. & West, A. (2014). Improving survival outcomes in lung transplant recipients through early detection of bronchiolitis obliterans: daily home spirometry versus standard pulmonary function testing. Canadian Journal of Respiratory Therapy, 50 (1), 17-22. (Level 1 evidence)

Russell, A., Adamali, H., Molyneaux, P., Lukey, P., Marshall, R., Renzoni, E., et al. (2016). Daily home spirometry: an effective tool for detecting progression in idiopathic pulmonary fibrosis. American Journal of Respiratory Critical Care Medicine, 2016 Apr 18 [Epub ahead of print]. Abstract retrieved June 2, 2016 from PubMed database.

Suhling, H., Dettmer, S., Rademacher, J., Greer, M., Shin, H., Tudorache, I., et al. (2012). Spirometric obstructive lung function pattern early after lung transplantation. Transplantation, 93 (2), 230-235. Abstract retrieved June 2, 2016 from PubMed database.

The International Society for Heart & Lung Transplantation, American Thoracic Society, European Respiratory Society. (2014). Clinical practice guideline: diagnosis and management of bronchiolitis obliterans syndrome. Retrieved June 2, 2016 from http://erj.ersjournals.com.

U. S. Food and Drug Administration. (2011, November). Center for Devices and Radiological Health. 510(k) Premarket Notification Database. K031643.(SpiroPD®) Retrieved June 2, 2016 from http://www.accessdata.fda.gov.

U. S. Food and Drug Administration. (2012, September). Center for Devices and Radiological Health. 510(k) Premarket Notification Database. K120635 (EasyOne®). Retrieved November 4, 2013 from: http://www.accessdata.fda.gov.

Wang, W., Finkelstein, S., Hertz, M., (September 2013) Automatic Event Detection in Lung Transplant Recipients Based on Home Monitoring of Spirometry and Symptoms. Telemedicine and e-Health. Vol 9, No. 9. 658-663. (Level 3 evidence)

ORIGINAL EFFECTIVE DATE:  12/13/2008

MOST RECENT REVIEW DATE:  5/11/2017

ID_BT

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