Abstract
Objective: To assess the impact of a telemedicine project that uses the Medtep platform in patients diagnosed with asthma. Method: An asthma consultation in the Integrated Care Management center of Albacete, in collaboration with the Pneumology department, which treat patients with possible asthma and/or acute asthma. In March of 2015 a group of 25 patients diagnosed with asthma, previously invited to participate in the study, were selected. Several training meetings were scheduled to assist them in using a web portal to control their asthma. They were also delivered a Peak-Flow and taught how it works. For 6 months clinical evolution and web portal entrances to follow. The data which was collected: smoking, how long they were diagnosed with asthma, asthma attacks, hospitalizations. Treatments- Evolution, According to patient level. Results: Out of the total 25 patients diagnosed, 17 (67%) were men and 8 (32%) women. The patient’s average age is of 34 years old. The total amount of smokers were 5 patients (20%), 3 of the remaining patients had never smoked. The average cigarette consumption of the smokers was of 2 packs a day. 42% had been diagnosed with asthma for less than 1 year; 20% between 1 and 5 years and the rest of patients had been diagnosed for over 5 years. Before entering the study, 50% had to attend emergency visits at least once (a year?), and some patients as much as 4 times in the last year. After entering the study, none of the patients had to attend ER visits. 80% of the total patients entered their health related data on a daily basis, as well as medication registers, which was above 95% in those who assiduously used the system. The total Peak flow of the patients saw an increase of 7% over baseline. More than 50% of patients increased their treatment before entering the study, and none and even 25% decreased their dose of treatment. 32% of patients have improved their level depending on the base treatment. Conclusions: Improvements in asthma control were achieved in patients who received Medtep Asthma support for 6 months, decreasing assistance in emergency services and, as a result, requiring less treatment.
Highlights
Asthma is a common chronic disease [1,2] characterised by chronic inflammation and/or structural changes of the airways, which leads to recurrent episodes of bronchial obstruction with wheezing, coughing, breathing difficulty, and/or chest tightness [3,4] as a consequence of bronchial hyperreactivity.According to clinical guidelines, treatment strategies for asthma should be aimed towards minimising symptoms, optimising lung function, and preventing symptom aggravation with few medication side effects
The average cigarette consumption of the smokers was of 2 packs a day. 42% had been diagnosed with asthma for less than 1 year; 20% between 1 and 5 years and the rest of patients had been diagnosed for over 5 years
Improvements in asthma control were achieved in patients who received Medtep Asthma support for 6 months, decreasing assistance in emergency services and, as a result, requiring less treatment
Summary
Asthma is a common chronic disease [1,2] characterised by chronic inflammation and/or structural changes of the airways, which leads to recurrent episodes of bronchial obstruction with wheezing, coughing, breathing difficulty, and/or chest tightness [3,4] as a consequence of bronchial hyperreactivity.According to clinical guidelines, treatment strategies for asthma should be aimed towards minimising symptoms, optimising lung function, and preventing symptom aggravation with few medication side effects. Most patients’ poor asthma control is due to diverse reasons: an incorrect diagnosis; the patient has other diseases with similar symptoms that create confusion, aggravating factors are not controlled; or the patient does not follow the treatment adequately. The first thing a patient should ask the doctor if the therapeutic response is not as expected, is if the patient meets the asthma treatment requirement. In a disease like asthma it is very difficult to use direct methods for assessing compliance (drug analytical measurements in biological samples), so we resort to indirect methods. Characteristics of the drugs used: device type, route of administration, complexity of the therapeutic regimen that shows the patient has not understood the instructions given by health providers, fear of side effects or increased price, presence of comorbidities that result in a complex treatment The high failure level caused by many factors: 1. Characteristics of the drugs used: device type, route of administration, complexity of the therapeutic regimen that shows the patient has not understood the instructions given by health providers, fear of side effects or increased price, presence of comorbidities that result in a complex treatment
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