title: Telehealth clinics increase access to care for adults with cystic fibrosis living in rural and remote Western Australia.
abstract: Introduction A significant proportion (15%, n = 28) of the adults with cystic fibrosis (CF) in Western Australia (WA) live in rural and remote areas and have difficulty accessing specialist care at the state adult CF centre, located in Perth. We aimed to increase access by offering telehealth clinics, and evaluate the impact on health outcomes. Methods Telehealth clinics were offered via videoconference over a 12-month period, with uptake and satisfaction measured at the end of the intervention. Participants could still attend in person clinics at the CF centre if requested. Other outcomes comprised healthcare utilisation (HCU), spirometry, weight and health-related quality of life. Results In 21 participants, total clinic visits increased from 46 (median (range) per participant 2 (0-6)) in the 12-month period preceding the study to 100 (5 (2-8), p < 0.001) during the intervention. Of the 100 clinics in total, 66 were delivered via telehealth. Satisfaction with telehealth was high and most (94%) participants agreed that telehealth is a good way to deliver CF care. An increase in intravenous antibiotic days (incident rate ratio (IRR) 2.3, p = 0.03) and hospital admission days (IRR 3.7, p = 0.01) was observed. There was an improvement in the vitality domain of the Cystic Fibrosis Questionnaire - Revised ( p < 0.05). Discussion Telehealth had good uptake and increased clinic attendance in adults with CF living in rural and remote WA, and had high satisfaction amongst participants. The increase in HCU, resulting from increased detection and treatment of exacerbations, may improve long-term outcomes in this population.
authors.affiliation: 1 School of Physiotherapy and Exercise Science, Curtin University, Perth, Western Australia.|2 Physiotherapy Department, Sir Charles Gairdner Hospital, Perth, Western Australia.|3 Institute for Respiratory Health, Sir Charles Gairdner Hospital, Perth, Western Australia.
authors.forename: Jamie
authors.initials: J
authors.lastname: Wood
authors.affiliation: 3 Institute for Respiratory Health, Sir Charles Gairdner Hospital, Perth, Western Australia.|4 Department of Respiratory Medicine, Sir Charles Gairdner Hospital, Perth, Western Australia.
authors.forename: Siobhain
authors.initials: S
authors.lastname: Mulrennan
authors.affiliation: 1 School of Physiotherapy and Exercise Science, Curtin University, Perth, Western Australia.|3 Institute for Respiratory Health, Sir Charles Gairdner Hospital, Perth, Western Australia.
authors.forename: Kylie
authors.initials: K
authors.lastname: Hill
authors.affiliation: 2 Physiotherapy Department, Sir Charles Gairdner Hospital, Perth, Western Australia.
authors.forename: Nola
authors.initials: N
authors.lastname: Cecins
authors.affiliation: 3 Institute for Respiratory Health, Sir Charles Gairdner Hospital, Perth, Western Australia.|4 Department of Respiratory Medicine, Sir Charles Gairdner Hospital, Perth, Western Australia.
authors.forename: Sue
authors.initials: S
authors.lastname: Morey
authors.affiliation: 1 School of Physiotherapy and Exercise Science, Curtin University, Perth, Western Australia.|2 Physiotherapy Department, Sir Charles Gairdner Hospital, Perth, Western Australia.|3 Institute for Respiratory Health, Sir Charles Gairdner Hospital, Perth, Western Australia.
authors.forename: Sue
authors.initials: S
authors.lastname: Jenkins
mesh_terms: D000328:Adult; D001835:Body Weight; D003550:Cystic Fibrosis / Q000628:therapy*; D005260:Female; D006296:Health Services / Q000706:statistics & numerical data; D006297:Health Services Accessibility / Q000458:organization & administration*; D006760:Hospitalization / Q000706:statistics & numerical data; D006801:Humans; D008297:Male; D017060:Patient Satisfaction; D011788:Quality of Life; D019035:Rural Health Services / Q000458:organization & administration* / Q000706:statistics & numerical data*; D013147:Spirometry; D011795:Surveys and Questionnaires; D017216:Telemedicine / Q000458:organization & administration*; D049269:Videoconferencing; D014904:Western Australia
keywords: Telehealth; cystic fibrosis; healthcare utilisation; rural and remote; videoconference