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10-06-2010 | Respiratory | Article

Internet application may improve asthma control

Abstract

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MedWire News: Results from a Dutch study show that an online weekly monitoring tool with medication adjustment advice can significantly improve disease control in patients with partly or uncontrolled asthma.

The researchers say that this “dynamic asthma management strategy reflects the varying and intermittent course of the disease, rather than doctor visits every 3 months as mentioned in international guidelines.”

Victor van der Meer (Leiden University Medical Center) and colleagues enrolled 200 patients, aged 18–50 years, with mild to moderate persistent asthma.

The participants were randomly assigned to an internet-based monitoring action plan (n=101) or usual care (n=99) for 1 year.

Each week, participants assigned to internet-based monitoring completed the Asthma Control Questionnaire (ACQ) and inputted data on self-measured FEV1 into a specifically designed website. Based on this data, the website issued weekly personalized advice on how to adjust treatment and a graphical representation of lung function over time.

Patients in the usual care group completed the ACQ at baseline, after 3 months, and at the end of the 1-year study period.

Well controlled asthma was defined as a score of less than 0.75 on the ACQ, partly controlled asthma as a score of 0.75–1.50, and uncontrolled disease as a ACQ score greater than 1.50.

In patients with well controlled asthma at baseline, there was no significant difference in ACQ scores at 1 year between the usual care and internet group.

However, in patients with partly controlled asthma at baseline, scores on the ACQ were 0.44 and 0.51 points lower at 3 months and 1 year, respectively, in the internet group compared with the usual care group.

And in patients with uncontrolled asthma at baseline, scores on the ACQ were 0.57 and 0.82 lower at 3 months and 1 year, respectively, in the internet group compared with the usual care group.

The researchers note that in patients with uncontrolled asthma at baseline, but not in those with well or partly controlled asthma, daily inhaled corticosteroid dose increased significantly in the first 3 months of the study in the internet group compared with the usual care group. However, there were no significant differences in daily inhaled corticosteroid or long-acting beta-2 agonist use between the internet group and usual care group at 1 year.

van der Meer and team conclude in the journal Respiratory Research: “Weekly self-monitoring and subsequent treatment adjustment leads to improved asthma control in patients with partly and uncontrolled asthma at baseline and tailors asthma medication to individual patients’ needs.”

They add: “Future asthma treatment strategies should incorporate continuous self-monitoring with use of a short validated questionnaire on asthma control.”

MedWire (www.medwire-news.md) is an independent clinical news service provided by Current Medicine Group, a trading division of Springer Healthcare Limited. © Springer Healthcare Ltd; 2010

By Mark Cowen

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