Cell phone-based interactive program improves asthma control
MedWire News: A cell phone-based interactive self-care program is more effective than a written action plan for improving asthma control in adults with the respiratory condition, results from a Taiwanese study show.
“Asthma is better controlled if patients self-monitor their symptoms and peak flow, follow a written action plan, and regularly visit their physician. However, a written action plan may be not comprehensive enough to provide guided self-management for all asthma events that happen at home,” explain Han-Pin Kuo (Chang Gung Memorial Hospital, Taipei) and team.
To investigate whether a cell phone-based self-care program can help improve asthma control, the researchers studied 89 patients with moderate-to-severe persistent asthma who were aged an average of 52 years.
The participants were randomly assigned to a cell phone-based self-care asthma management group (n=43) or a control group (n=46).
Patients in the control group received a written action plan with detailed instructions on daily self-management, including daily peak expiratory flow rate (PEFR) measurement, as well as guidelines for handling exacerbations and emergencies. They were also taught how to adjust their medications based on daily symptoms and PEFR measurement.
Patients in the cell phone group received specifically designed software loaded onto their phones that included an electronic diary to record daily asthma symptom scores. The scores were based on sleep quality, severity of coughing, difficulty in breathing, daily activities affected by asthma, use of relievers, daily PEFR, and PEFR variability.
Based on this data, which were uploaded onto a server run by the Taiwan Chest Disease Association, the patients received assessment of their asthma status and corresponding management advice, including information on medication adjustment.
The researchers found that mean PEFR increased significantly over the 6-month study period among patients in the cell phone group, from 352.2 l/min at baseline to 376.3 l/min at 3 months, and 382.7 l/min at 6 months. In contrast, there was no significant improvement in PEFR among participants in the control group from a mean baseline level of 350.1 l/min.
Mean percent of predicted FEV1 also improved in the cell phone group, from 57.9% at baseline to 63.7% at 3 months, and 65.2% at 6 months. Again, there was no such improvement among patients in the control group.
Patients in the cell phone group also experienced significantly greater improvements in quality of life (QoL) and fewer exacerbations and unscheduled clinic visits during the study period than those in the control group.
Kuo and team conclude in the European Respiratory Journal: “The results demonstrate that cell phone-based interactive self-care system may offer a better self-management of asthma than a written action plan in terms of improving pulmonary function (FEV1 and PEFR) and QoL, and decreasing episodes of exacerbation and unscheduled visits.”
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By Mark Cowen