1. Monitoring COPD and asthma: technological developments in the IMCA II Project Enric Duran Municipal Institut of Medical Research (IMIM) Workshop on Health Examination Surveys Luxembourg, 9 -11 April 2008

2. IMCA II Working Packages overview WP 1: Coordination of the project. WP 2: Dissemination of the results. WP 3: Evaluation of the project. WP 4: Indicators from routine database. WP 5: Indicators from international research studies. WP 6: HES Feasibility Study Respiratory Health Survey in the Elderly

3. HES Feasibility Study Objectives To assess the feasibility of using Motohealth system as a tool for performing interviews and measurements at home in the context of large scale respiratory surveys at national and international level. To evaluate to what extent the Motohealth system can improve response rates to questionnaires, the acceptability of measurements performance and biological samples collection when the measurements are performed at home in comparison to other settings such as a primary health care centre.

4. Methodology Study design: randomized controlled trial Random sample N=250 From small GA Group A N=125 Fiedwork at home Group B N=125 Fieldwork at the PCC (Model A) Model B

5. Methodology Study design and population Which model will perform each country? –Spain has choosen Model A. –Sweden, Germany, Italy (Pisa &Roma) have to decide which model they choose. –Other countries may considerer to perform the study with funding available: France, Poland, Norway and Finland. –Other countries despite funding difficulties can explore ways of making it possible (national funding or helping them to obtain funding).

6. Methodology Technology and communication system MOTOHEALTH System

7. Methodology Technology and communication system (MOTOHEALTH) MOTOHEALTH is a tool which integrates questionnaire design, field work management, measurements performance, data collection and transmission on line with high eficiency and quality reducing costs and time for data analysis.

8. Methodology Technology and communication system (MOTOHEALTH) Is an integrated mobile monitoring system. Allows remote monitoring of chronic patients or healthy individuals. Transmits the data through wireless communication (GPRS) in a secure mode to a central repository server. Professionals review the data and take decisions accordingly to patient/individual situation.

9. The system integrates three main applications: Backend Application (BEA): this is the application for study administration, importing individuals to the system and the administration of professionals involved in the study. Survey Application (SVA): this is the application administered by the field worker for the measurements performance and questionnaires completion at individuals home. Geographic Location Application (GLA): this is the application that facilitates the work of the phone operators for the the individuals scheduling visits according to a geographical area. Methodology Technology and communication system (MOTOHEALTH)

10. Methodology Technology and communication system Wireless sensors, handset/computer, call center, central server

11. Login Login ( https://linkcare.clinic.ub.es/mhworld/ )https://linkcare.clinic.ub.es/mhworld/ Methodology Technology and communication system Acces to MOTOHEALTH

12. Key professionals involved and roles SM Phone operator Field worker Study Manager

13. PC portàtil Overview of the fieldwork materials and tools? Study manager SM

14. Methodology Measurements performed and sensors characteristics Spirometry (NDD Easy One Model 2001). Blood pressure monitor UA -767BT (A&D Medical). Pulse-oximetry (NONIN 4000 Avant Bluetooth). Weight (A&D - Medical UC-321PL). Height (Laser). Blood sample: Hemograme, Cholesterol, C-Reactive Proteine and Creatinine.

15. Study Manager and human resources 4 Field workers 2 Phone operators 1 Study manager 1 Pediatric nurse FW PO PN SM FW PO HES Feasibility Study in Barcelona Barcelona option: SM

16. Field worker activities Participant Confirm visit Consent form Questionnaire & measurements Consent form Questionnaire & measurements Study information Synchronize Field Worker Synchronize Interview results

17. Phone operator activities Consent form Participant Schedule a visit Brief Questionnaire Questionnaire & measurements Check participant’s data Phone Operator Study information

18. Methodology Questionnaires selected (Adults & Children) Adults questionnaire: GA 2 LEN screening quetionnaire. –21 questions. –Translated to four languages or more. Children’s questionnaire: ISAAC II protocol (selected questions): –32 questions. –Translated to four languages or more.

19. Methodology Consent Form Which are the options for all individuals? –A) The questionnaire and all described measurements. –B) The questionnaire and all marked measurements: –Weight and height –Spirometry –Pulse-oximetry –Blood pressure –Blood extraction –C) Only the questionnaire. –Blood extraction

20. What we expect from the technology used in this study? MOTOHEALTH System

21. Web IMCA: www.imca.cat