Home-Based Spirometry Telemonitoring After Allogeneic Hematopoietic Cell Transplantation: Mixed Methods Evaluation of Acceptability and Usability

Ajay Sheshadri, Sukh Makhnoon, Amin M. Alousi, Lara Bashoura, Rene Andrade, Christopher J. Miller, Karen R. Stolar, Muhammad Hasan Arain, Laila Noor, Amulya Balagani, Akash Jain, David Blanco, Abel Ortiz, Michael S. Taylor, Alex Stenzler, Rohtesh Mehta, Uday R. Popat, Chitra Hosing, David E. Ost, Richard E. ChamplinBurton F. Dickey, Susan K. Peterson

Research output: Contribution to journalArticlepeer-review


Background: Home-based spirometry (HS) allows for the early detection of lung complications in recipients of an allogeneic hematopoietic cell transplant (AHCT). Although the usability and acceptability of HS are critical for adherence, patient-reported outcomes of HS use remain poorly understood in this setting. Objective: The aim of this study is to design a longitudinal, mixed methods study to understand the usability and acceptability of HS among recipients of AHCT. 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 experiences 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: Recipients of AHCT found HS to be highly acceptable despite modest technological barriers. On average, participants believed that the HS was helpful in managing symptoms related to AHCT (scores ranging from 2.22 to 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 the patient perception of HS. Conclusions: Study participants found HS acceptable and easy to use. Some modifiable technical barriers to performing HS were identified; however, wider implementation of pulmonary screening is feasible from the patient’s perspective.

Original languageEnglish (US)
Article numbere29393
JournalJMIR Formative Research
Issue number2
StatePublished - Feb 1 2022
Externally publishedYes


  • Acceptability
  • Allogeneic hematopoietic cell transplantation
  • Feasibility
  • Home-based
  • Home-based spirometry
  • MHealth
  • Mixed methods evaluation
  • Mobile phone
  • Patient perspectives
  • Pulmonary medicine
  • Remote care
  • Respirology
  • Spirometry
  • Usability

ASJC Scopus subject areas

  • Health Informatics
  • Medicine (miscellaneous)


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