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Published Online: 22 March 2005

Improving Asthma Control Through Telemedicine: A Study of Short-Message Service

Publication: Telemedicine Journal & e-Health
Volume 11, Issue Number 1

Abstract

Home peak expiratory flow (PEF) measurement is recommended by asthma guidelines. In a 16-week randomized controlled study on 16 subjects with asthma (24.6 ± 6.5 years old, asthma duration з 6 months), we examined Global System for Mobile Communications (GSM) mobile telephone short-message service (SMS) as a novel means of telemedicine in PEF monitoring. All subjects received asthma education, self-management plan, and standard treatment. All measured PEF three times daily and kept a symptom diary. In the study group, therapy was adjusted weekly by an asthma specialist according to PEF values received daily from the patients. There was no significant difference between the groups in absolute PEF, but PEF variability was significantly smaller in the study group (16.12 ± 6.93% vs. 27.24 ± 10.01%, p = 0.049). forced expiratory flow in 1 second (FEV1; % predicted) in the study group was slightly but significantly increased (81.25 ± 17.31 vs. 77.63 ± 14.80, p = 0.014) and in the control group, unchanged (78.25 = 21.09 vs. 78.88 = 22.02, p = 0.497). Mean FEV1 was similar in the two groups both before and after the study. Controls had significantly higher scores for cough (1.85 ± 0.43 vs. 1.42 ± 0.28, p < 0.05) and night symptoms (1.22 ± 0.23 vs. 0.85 ± 0.32, p < 0.05). There was no significant difference between the groups in daily consumption of inhaled medicine, forced vital capacity, or compliance. Per patient, per week, the additional cost of follow-up by SMS was € 1.67 (equivalent to approximately $1.30 per 1 Euro), and SMS transmission required 11.5 minutes. Although a study group of 40 patients is needed for the follow-up study to achieve the power of 80% within the 95% confidence interval, we conclude that SMS is a convenient, reliable, affordable, and secure means of telemedicine that may improve asthma control when added to a written action plan and standard follow-up.

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Published In

cover image Telemedicine and e-Health
Telemedicine Journal & e-Health
Volume 11Issue Number 1February 2005
Pages: 28 - 35
PubMed: 15785218

History

Published online: 22 March 2005
Published in print: February 2005

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Vedran Ostojic, M.D.
Division of Clinical Immunology and Pulmonology, Department for Internal Diseases, General Hospital "Sveti Duh," Zagreb, Croatia.
Branimir Cvoriscec, M.D., Ph.D.
Division of Clinical Immunology and Pulmonology, Department for Internal Diseases, General Hospital "Sveti Duh," Zagreb, Croatia.
Sanja Barsic Ostojic, M.D.
Division of Clinical Immunology and Pulmonology, Department for Internal Diseases, General Hospital "Sveti Duh," Zagreb, Croatia.
Dimitry Reznikoff, M.D.
Department of Internal Medicine, Winthrop University Hospital, Mineola, New York.
Asja Stipic-Markovic, M.D., Ph.D.
Division of Clinical Immunology and Pulmonology, Department for Internal Diseases, General Hospital "Sveti Duh," Zagreb, Croatia.

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