Assessing the acceptability and feasibility of remote spirometric monitoring for rural patients with interstitial lung disease: a multimethod approach

Table 3 Qualitative Interviews

Barriers to ILD care
Themes	Categories	Examples:
Travel	Distance	“I think the biggest challenge is just the distance that you have to travel from home to Indy. It's a three-hour drive for us”
Travel	Travel burden	“I had to bring my own oxygen. So I think I had 32 oxygen tanks in the back of her truck”
Cost	Money	“The money, the cost to drive to Indy can be a burden” “I mean, they're (PFTs) expensive”
Cost	Time	“it's a 90-min drive each way just to go to the doctor's office”
(Un)Availability of local expertise	Healthcare	“A small town might have its advantages, but when it comes to healthcare, not so much”
	ILD familiarity	“In my area, people don't really know about it”
	Resources	“They don't have the equipment (PFTs)”

Facilitators to ild care: telemedicine/home monitoring
Themes	Categories	Examples:
Improved Access	Health care team	“I think you might be able to get in sooner”
Improved Access	Resources	“You can do it at home (PFTs)”
Savings	Time	“And you don't have to travel down to Indy with no oxygen tank.”
Savings	Money	“It's something that's probably very cost-effective for both patients and doctor”
Home Monitoring	Awareness	“While I don't know what some of the numbers mean, I can certainly see the trends, and if I see the trends going badly, then it gives me an opportunity to call the doctor's office”
Home Monitoring	Empowerment	“I do believe it empowers the patient to be more of an advocate for their own care”

Technology: merits/limitations
Themes	Examples
Merits	“Well, I think technology is the way of the world now, so I think the right devices and the right things to help manage your disease, it can't do nothing but help” “Well, it's better, and it's faster, and it's much more convenient”
Limitations	“One disadvantage is they can't actually see you hands on. He can't listen to my lungs on telehealth or something like that” “I just think personal contact is important” “The disadvantages are, as I mentioned, the low signal strength and just, essentially, lack of coverage where I live”

ILD interstitial lung disease, PFT pulmonary function test
The table depicts the themes which we developed from analyzing data about barriers to ILD care in general, and how telemedicine and remote monitoring with spirometry can serve as a facilitator to improved access and overcome common barriers to ILD care for patients in rural areas

ISSN: 1465-993X