Remote monitoring and teleconsultations can reduce greenhouse gas emissions while maintaining quality of care in cystic fibrosis

Abstract

Background: Remote care usefulness and climate change co-benefits should be addressed simultaneously to incentivize political action.

Objectives: To assess the changes in healthcare consumption, lung function and greenhouse gas (GHG) emissions during the COVID-19 pandemic in Dutch cystic fibrosis (CF) care.

Design: Retrospective multicentre observational study in five Dutch CF centres.

Methods: Eighty-one participants were included. Healthcare consumption was described alongside the COVID-19 Stringency Index (2019-2022). Travel related GHG emissions were calculated for every clinic visit. Changes in percentage predicted Forced Expiratory Volume in one second (ppFEV1) were assessed using a paired-samples T-test.

Results: Healthcare consumption patterns followed COVID-19 public health measure stringency but returned back to the "old normal". Emission of 5.450, 3 kg of carbon dioxide equivalents were avoided while quality of care was relatively preserved. ppFEV1 declined as expected (ΔMeans 3.69%, 95%CI 2.11-5.28).

Conclusion: Remote monitoring of lung function and symptoms and teleconsultations in CF can reduce GHG emissions while maintaining quality of care. As health sectors constitute a large share of national climate change footprints, digital health can partly alleviate this burden by reducing private travel.

Keywords: climate co-benefits; cystic fibrosis; pediatrics; respiratory medicine; spirometry; telehealth; telemonitoring.

Figure 1

Patterns of healthcare consumption during every month plotted from march 2019 until march 2022 against the Dutch COVID-19 stringency Index (grey shaded area). Upper panel: Physical outpatient visits vs. teleconsultations. Lower panel: Clinic spirometry vs. home spirometry. Primary Y-axis represents COVID-19 Stringency Index value; secondary Y-axis represents healthcare consumption data.