Introdução à Medicina Faculdade de Medicina da Universidade do Porto Introdução à Medicina Home monitoring in respiratory chronic diseases: systematic review Turma 19 Orientador: Dr. João Fonseca

Summary:  Key-words;  Abstract;  Introduction;  Querys;  Participants and Methods;  Expected Results;  Task description;  Acknowledgements;  References.

KEY-WORDS  KEY-WORD: Home monitoring; Home Care Services; Chronic diseases; Asthma; COPD; Cystic Fibrosis;

ABSTRACT Aim: Analyse the present situation of home monitoring in respiratory chronic diseases: Asthma, COPD and Cystic Fibrosis; methods: systematic review and meta analysis of randomized controlled studies published in the years 1996 to 2005 indexed at SCOPUS; results/discussion: If the chosen publications were similar, in other words, if the sample, the intervention and the conclusions were the same, it will be done, afterwards, a statistic analysis.

INTRODUCTION  Meta-analysis – definition: Statistic review, achieved by the analysis of a huge number of articles, so that is possible to systematize the most credible information as possible; it allows an easy analyse of the knowledge of different studies in the way that their information is systematized in one single article; it is possible to obtain conclusion quickly that easily describe our reality in study

INTRODUCTION Patients with respiratory chronic diseases may benefit from the regular assessment of their condition in their daily- lives. This monitorization between observations at medical facilities has the potential:  for detecting early negative events  for providing a better insight to the variations of the disease  to foster patients participation in their own care. It is insufficiently known what are the methods, the diseases and the patients’s characteristics associated with better outcomes when using home monitoring.

INTRODUCTION  Home monitoring in respiratory chronic diseases– definition: Group of tests that measure the function of airways; Used by many patients to monitoring their lung function outside the hospital; Allows to anticipate when their breathing will become worse and to take the appropriate cares.

Asthma  Definition: disease characterized by recurrent attacks of breathlessness and wheezing, which vary in severity and frequency (WHO)  Why did we choose this chronic disease? It’s very frequent, mostly in childrens. Despite advances in the treatment of asthma the mortality of this disease has increased significantly in the past several years. Lack of live quality of those who have it.

COPD  Definition: chronic obstructive pulmonary disease state characterized by a reduction of the maximal airflow with variable degrees of air sack enlargement and lung tissue destruction. Emphysema and chronic bronchitis are the most common forms of COPD. (WHO)  Why did we choose this chronic disease? It’s very frequent; has a high level of mortality. Lack of live quality of those who have it

Cystic Fibrosis  Definition: hereditary disease in which the lungs, liver and pancreas secrete large amounts of thick mucus. Cystic fibrosis, also called mucoviscidosis, cannot be cured.(WHO)  Why did we choose this chronic disease? No cure is known, but health can be improved and life extended considerably with attention to pulmonary complications.

Aims  Compare home monitoring with hospital monitoring, within asthma;  Compare the efficiency of different techniques within asthma (spirometry, telemonitoring, Global System for Mobile Comunication, SMS, Internet, FOT (forced oscillation technique)) and COPD (spirometry, pulse oximetry, Home automated telemanagement (HAT), ehealth);  In witch illness spirometry is more efficient;  Compare the efficiency of Global System for Mobile Communication, SMS, Internet in Asthma and COPD;  Which techniques show evidence to bring advantages of being used (economically, clinical).

QUERYS - Home monitoring of respiratory chronic diseases AND Asthma OR COPD OR Cystic Fibrosis; - Home Care Services AND Asthma OR COPD OR Cystic Fibrosis.

PARTICIPANTS AND METHODS Systematic review and meta analysis of randomised controlled studies published in the years 1996 to 2005 indexed at SCOPUS, assessing the benefits of using home monitoring in patients with chronic respiratory diseases such as: Asthma, COPD and Cystic Fibrosis.

Inclusion Criteria:  Randomised controlled studies;  Those which describe and evaluate the health care of patients outside hospital, with Asthma, COPD and Cystic Fibrosis, using certain quality parameters.

Exclusion criteria:  Those publications that evaluate interventions in animals;  Those that are only concerned about: Therapy; Pharmacology intervention; Exclusively turned to education of patients and professionals.  No control groups

FLOWCHART

RESULTS  Expected results: If the chosen publications were similar, in other words, if the sample, the intervention and the conclusions were the same, it will be done, afterwards, a statistic analysis, using software such as SPSS.

TASK DESCRIPTION GANTT MAP

Faced problems: These are the problems we faced during the first stage of our work:  Lack of time;  Great number of diseases that could be studied;  Great number of useless articles;  Lack of techniques to compare

ACKNOWLEDGEMENTS We would like to thank Dr. João Fonseca

REFERENCES   WHO (world health organization)  “Telematic system for monitoring of asthma severity in patients' homes”; Finkelstein, J., Hripcsak, G., Cabrera, M. Correspondence address Department of Medical Informatics, Columbia University, New York, USA.