Telespirometry: novel system for home monitoring of asthmatic patients.

OBJECTIVES To describe a newly developed telespirometry system consisting of a portable spirometer that transmits the lung ventilatory values by telephone from the patient's home to a remote monitoring center and to assess the ability of the telespirometry system to detect early signs of asthmatic deterioration. METHODS Thirty-nine patients with moderate to severe asthma were monitored with the telespirometry system. The lung function testing and transmission of the spirometric data by telephone from the patient's home to a remote monitoring center were performed according to the patient's judgment. All previous transmissions of the spirometric data were analyzed retrospectively to detect early signs of asthmatic deterioration, which resulted in dispatch of the mobile intensive care unit (MICU) to the patient's home. RESULTS In 19 patients (49%), analysis of the spirometric data detected early signs of asthmatic deterioration. Analysis of the spirometric data correlated with decisions to dispatch the MICU in 22 of 39 (56%) patients. In patients with severe asthma, the decision was made during oral communication between the patient and the operator and was based on clinical impression rather than functional results. CONCLUSION Home monitoring of asthmatic patients with the telespirometry system may improve the management of the disease and the quality of life and reduce costly hospitalizations.

[1]  P. Paré,et al.  Small airway dimensions in smokers with obstruction to airflow. , 1990, The American review of respiratory disease.

[2]  Bob Margulies,et al.  Task force report , 1991 .

[3]  W. Bailey,et al.  Measures for use in asthma clinical research. Overview of the NIH workshop. , 1994, American journal of respiratory and critical care medicine.

[4]  J. Li Home peak expiratory flow rate monitoring in patients with asthma. , 1995, Mayo Clinic proceedings.

[5]  P. Paré,et al.  Small airways dimensions in asthma and in chronic obstructive pulmonary disease. , 1993, The American review of respiratory disease.

[6]  M. Epstein,et al.  DESFERRIOXAMINE AND IRON. , 1964, Lancet.

[7]  T. Creer,et al.  A procedure for using peak expiratory flow rate data to increase the predictability of asthma episodes. , 1978, The Journal of asthma research.

[8]  Buist As Standardization of spirometry. , 1987 .

[9]  J. G. Douglas,et al.  Effectiveness of routine self monitoring of peak flow in patients with asthma , 1994 .

[10]  P. Paré,et al.  The mechanics of airway narrowing in asthma. , 1989, The American review of respiratory disease.

[11]  S. Holgate,et al.  A self management plan in the treatment of adult asthma. , 1989, Thorax.

[12]  M A Mullee,et al.  Evaluation of peak flow and symptoms only self management plans for control of asthma in general practice. , 1990, BMJ.

[13]  S. Quirce,et al.  Peak expiratory flow monitoring is not a reliable method for establishing the diagnosis of occupational asthma. , 1995, American journal of respiratory and critical care medicine.

[14]  Sly Rm Asthma mortality, East and West , 1992 .

[15]  P. Gergen,et al.  The increasing problem of asthma in the United States. , 1992, The American review of respiratory disease.

[16]  W. Bailey,et al.  A randomized trial to improve self-management practices of adults with asthma. , 1990, Archives of internal medicine.

[17]  P. Sly,et al.  Accuracy of mini peak flow meters in indicating changes in lung function in children with asthma , 1994, BMJ.

[18]  I. Bruderman,et al.  Assessment of a new transtelephonic portable spirometer. , 1996, Thorax.