A mobile telephone-based interactive selfcare system improves asthma control W-T. Liu, C-D. Huang, C-H. Wang, K-Y. Lee, S-M. Lin and H-P. Kuo Eur Respir.

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A mobile telephone-based interactive selfcare system improves asthma control W-T. Liu, C-D. Huang, C-H. Wang, K-Y. Lee, S-M. Lin and H-P. Kuo Eur Respir J 2011; 37: 310 – 317 호흡기내과 R3 구자 원

Background Asthma (7.8% in Taiwan) ◦ Common problem - Lack of long-term care, poor compliance, monitoring and assessment by symptoms and signs only, shortage of education ◦ Short Message Service(SMS) – convenient, reliable, affordable and secure means of telemedicine  improve asthma control ◦ Internet-baced asthma telemonitoring programme : Improve outcomes, but time-consuming and staff-heavy ◦ Mobile telephone-based system : good compliance and clinical outcomes in COPD AIM Whether a self-care system will achieve better asthma control through a mobile telephone-based interactive programme.

Methods Study subjects and desing Prospective randomised controlled study 120 Pts. Moderate to severe persistent asthma, in Taiwan Outpatient clinincs of Chang Gung Memorial Hospital Inclution criteria - American Thoracic Society asthma definition Global interactive for Asthma guidline(GINA), Education - asthma, self management plan, standard treatment Daily peak expiratory flow rate and asthma symptoms

Mobile telephone-based interactive asthma self-care system Mobile telephone-based interactive self-care software. Electronic diary : daily asthma symptom score, use of relievers, peak expiratory flow rate(PEFR) and PEFR variability Level of asthma control assessed by PEFR, Need for reliever use, daily asthmatic symptoms assessed by GINA guidelines 2006

After uploading the diary data, received the assessment of their asthma status and corresponding management advice immediately

Control group Asthma symptom diary booklet – record PEFR regularly Asthma action plan – detailed instructions for daily self-management, guidelines for handling exacerbations and emergencies. Statistical analysis One-way ANOVA, Mann-Whitney test, Chi-squared test P-value <0.05

Discussion The incresed dosage of corticosteroids and antileukotrienes (increased dosage of anti-inflammatory agents)  Better asthma control Early medical intervention may be implemented to prevent deterioration. Regular assessment  sufficient anti-inflammatory treatment and avoid unnecessary treatment The mobile telephone-based self-care system ◦ Feasible and acceptable method for self-monitoring ◦ Immediate response ◦ A promising intervention to promote good communication between patients and caregivers. ◦ User-friendly software

Limitation ◦ Small sample size ◦ Single-center study ◦ Difficult to operate this system ◦ Pilot study Conclusion A mobile telephone-based interactive self-care system is a promising tool for supporting the self-management of asthma Patients increased their awareness of asthma control, and benefited from a reduced rate of acute exacerbations and improved pulmonary function, as well as improved QoL, through early medical intervention.