An Internet-Based Interactive Telemonitoring System for Improving Childhood Asthma Outcomes in Taiwan

Jan, Ren Long; Wang, Jiu Yao; Huang, Mei Chih; Tseng, Shin Mu; Su, Huey Jen; Liu, Li Fan

doi:10.1089/tmj.2006.0053

Cited by 142 publications

(165 citation statements)

References 25 publications

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“…The results of Jan et al 54 are supported by other studies in the field, such as that by Rasmussen et al 55 In this study, it was demonstrated in an RCT of 300 adults with asthma that an IHCA was able to increase the patient's adherence to asthma medication, improve clinical outcomes, and improve the patient's quality of life. 55 Although effect sizes were not reported for this study, it provides supporting evidence concerning the long-term positive effects of IHCAs in the area of patient adherence to medications.…”

supporting

confidence: 74%

“…These interventions typically involve online monitoring of symptoms, health education, counseling, feedback, and prompts regarding medication use. Jan et al 54 found that an Internetbased interactive program was able to improve patient monitoring of asthma symptoms significantly and adherence with asthma medications over the course of a 12-week RCT. These increased adherence rates led to improved clinical outcomes among the intervention sample.…”

mentioning

confidence: 99%

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Computer-based interactive health communications for people with chronic disease

Casey¹,

Clough²,

Mihuta³

et al. 2014

SHTT

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Chronic diseases (CD) -such as cardiovascular, diabetes, cancer, and chronic respiratory diseases -are projected to be the most common causes of mortality and morbidity by 2030. Use of a participatory decision-making model that emphasizes a partnership among practitioners, patients, and their families to achieve desired goals is a key strategy in achieving optimal outcomes. The Interactive Health Communication Applications (IHCAs) can support participatory decision making by providing the unique infrastructure needed to deliver support for the multiple requirements of patients with CD. The aim of this paper is to provide a descriptive review of the use of IHCAs in the treatment of chronic disease. Patient acceptability and satisfaction were identified as key issues that can be enhanced by ensuring that IHCAs provide: 1) emotional support and empowerment; 2) education and information from health professionals; and 3) telecommunication instead of onsite visiting. An important benefit of IHCAs can be an improved quality of communication between the patients and the health care professionals, which is a critical and predictive factor of treatment outcomes for many patients with CD. Similarly, there is good evidence to suggest that IHCAs can improve the patients' adherence to both medication and behavioral regimens designed to both treat and manage CDs. However, it is important to recognize that the technological development and effective implementation of an ICHA is a complex multidisciplinary operation that needs to take into account the needs of the various stakeholders as well as making use of the most suitable technology.

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supporting

confidence: 74%

mentioning

confidence: 99%

Computer-based interactive health communications for people with chronic disease

Casey¹,

Clough²,

Mihuta³

et al. 2014

SHTT

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“…Recently, a systemic review of home telemonitoring for patients with respiratory conditions, particularly when evaluated in randomised controlled trials in asthma, showed that home telemonitoring of respiratory conditions results in early identification of deteriorations in patient condition and symptom control [12][13][14][15][16][17]. In Taiwan, an internet-based asthma telemonitoring programme reportedly increased self-management skills and improved asthma outcomes, and appeared to be an effective technology for care that is well accepted by asthmatic children and their caregivers [13]. However, telephone communication is time-consuming and staff-heavy, while internet access is not always convenient.…”

mentioning

confidence: 99%

A mobile telephone-based interactive self-care system improves asthma control

et al. 2010

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The self-management of asthma can improve clinical outcomes. Recently, mobile telephones have been widely used as an efficient, instant personal communication tool. This study investigated whether a self-care system will achieve better asthma control through a mobile telephone-based interactive programme.This was a prospective, controlled study in outpatient clinics. From 120 consecutive patients with moderate-to-severe persistent asthma, 89 were eventually recruited for the study, with 43 in the mobile telephone group (with a mobile telephone-based interactive asthma self-care system).In the mobile telephone group, mean¡SEM peak expiratory flow rate significantly increased at 4 (378.2¡9.3 L?min ; n543; p50.001) compared to the control group. Mean¡SEM forced expiratory volume in 1 s significantly increased at 6 months (65.2¡3.2% predicted; n543; p,0.05). Patients in the mobile telephone group had better quality of life after 3 months, as determined using the Short Form-121 physical component score, and fewer episodes of exacerbation and unscheduled visits than the control group. Patients in the mobile telephone group significantly increased their mean daily dose of either systemic or inhaled corticosteroids compared with the control group.The mobile telephone-based interactive self-care system provides a convenient and practical self-monitoring and -management of asthma, and improves asthma control.

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“…The comparison between the standard clinical care and the clinical trial with telemonitoring showed a potential saving by telemonitoring of €40,397.00 per patient for a 10 year period 15 . In asthma, home monitoring is more extensively studied, although only a few studies investigated the effects of home monitoring of the combination of lung function and respiratory symptoms 18 . In a recent study of our research group in 96 children with asthma, more cases of less well-controlled asthma were detected by prospective home monitoring of FEV 1 and symptoms than by a validated questionnaire during hospital visits 5 .…”

Section: Discussionmentioning

confidence: 99%

Early detection of pulmonary exacerbations in children with cystic fibrosis by electronic home monitoring of symptoms and lung function

Dompeling

Horck

Winkens³

et al. 2016

7.3 Cystic Fibrosis

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Pulmonary exacerbations (PEx) in Cystic Fibrosis (CF) are associated with an increased morbidity and even mortality. We investigated whether early detection of PEx in children with CF is possible by electronic home monitoring of symptoms and lung function. During this one-year prospective multicentre study, 49 children with CF were asked to use a home monitor three times a week. Measurements consisted of a respiratory symptom questionnaire and assessment of Forced Expiratory Volume in one second (FEV1). Linear mixed-effects and multiple logistic regression analyses were used. In the 2 weeks before a PEx, the Respiratory Symptom Score (RSS) of the home monitor increased (p = 0.051). The FEV1 as percentage of predicted (FEV1%pred) did not deteriorate in the 4 weeks before a PEx. Nevertheless, the FEV1%pred at the start of exacerbation was significantly lower than the FEV1%pred in the non-exacerbation group (mean difference 16.3%, p = 0.012). The combination of FEV1%pred and RSS had a sensitivity to predict an exacerbation of 92.9% (CI 75.0-98.8%) and a specificity of 88.9% (CI 50.7-99.4%). The combination of home monitor FEV1%pred and RSS can be helpful to predict a PEx in children with CF at an early stage.Pulmonary exacerbations in Cystic Fibrosis (CF) are important events, associated with an accelerated decline in lung function and an increased morbidity and even mortality 1 . Prevention of pulmonary exacerbations (PEx) is one of the main goals in the management of CF 2 . Currently, treatment of a PEx starts when a patient presents with an increase in (respiratory) complaints, a deterioration in lung function and/or weight loss. It often takes some time before a patient with more complaints seeks medical care. This patient delay may introduce a subsequent delay in starting antibiotic treatment, potentially resulting in a more severe course of the PEx, and a higher risk of permanent lung function loss.There are some known risk factors for PEx in children, including frequency of previous PEx, a lower baseline Forced Expiratory Volume in one second (FEV 1 ), and female sex 3 . However, in individual cases these factors do not help to decide when to start therapy timely. As PEx cannot be predicted reliably yet, there is a need for a method to detect PEx at an earlier stage. Electronic home monitoring may be useful to detect changes in lung function and respiratory complaints at an early stage. It provides the opportunity to assess symptoms and lung function on a daily or weekly basis. Data can be sent to the CF centre where they can be evaluated. In this way, disease deterioration and the occurrence of PEx may be detected earlier.

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An Internet-Based Interactive Telemonitoring System for Improving Childhood Asthma Outcomes in Taiwan

Cited by 142 publications

References 25 publications

Computer-based interactive health communications for people with chronic disease

Computer-based interactive health communications for people with chronic disease

A mobile telephone-based interactive self-care system improves asthma control

Early detection of pulmonary exacerbations in children with cystic fibrosis by electronic home monitoring of symptoms and lung function

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