Abstract

Introduction: Variable airflow obstruction that can be confirmed by diurnal variability of peak expiratory flow (PEF) >13% is an important characteristic of asthma. Home monitoring of PEF may be helpful to diagnose and monitor asthma. In this feasibility study, we aimed to study if asthmatic children can measure PEF at home twice daily during a 4-week period using a device designed as a “whistle” and a smart phone software application.Materials and Methods: Twice daily during 4 weeks, children aged 5–12 years with current asthma rated their asthma condition electronically on the smart phone application Blowfish before inhaling deeply then exhaling into the device to produce a high-pitched sound recorded by the application. Through mathematical algorithms, the sound was transferred to PEF, which was uploaded to a server. At inclusion, the Pediatric Asthma Quality of Life Questionnaire and the Childhood Asthma Control Test were answered. At the end, the parents graded the device and application.Results: One child did not manage to upload PEF. For the remaining 21 children, the median (quartiles) days with at least one measurement during the period were 27 (21–29.5), and on median 18 (9–24) days PEF was recorded twice daily. The median parental score (potential score 0–20) of the application was 18 (15–20).Discussion/Conclusion: The study shows promising results for home monitoring of PEF by an electronic device with automatic teletransmission. The high rate of successful recordings and parental satisfaction suggests that the clinical utility of the solution should be further studied.

Highlights

  • Variable airflow obstruction that can be confirmed by diurnal variability of peak expiratory flow (PEF) >13% is an important characteristic of asthma

  • Airflow variability may be confirmed by >12% increase in forced expiratory flow in 1 second (FEV1) after inhaling a bronchodilator or after 4 weeks of antiinflammatory treatment.[1]. These features may not always be present or easy to assess in children with asthma, and airflow variability may be confirmed by diurnal variability of peak expiratory flow (PEF) >13%

  • The impact of telemedicine on monitoring asthma in from Global initiative for asthma, an excessive variability in children is not properly studied due to various and still intwice-daily PEF >13% during 2 weeks may be helpful in confirming the asthma diagnosis.[1]

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Summary

Introduction

Variable airflow obstruction that can be confirmed by diurnal variability of peak expiratory flow (PEF) >13% is an important characteristic of asthma. Home monitoring of PEF may be helpful to diagnose and monitor asthma In this feasibility study, we aimed to study if asthmatic children can measure PEF at home twice daily during a 4-week period using a device designed as a ‘‘whistle’’ and a smart phone software application. Materials and Methods: Twice daily during 4 weeks, children aged 5–12 years with current asthma rated their asthma condition electronically on the smart phone application Blowfish before inhaling deeply exhaling into the device to produce a highpitched sound recorded by the application. There is less evidence to support the routine use of PEF recording in the diagnosis and monitoring of asthma in children.[2] In addition, both multiple and daily PEF recordings are needed to obtain reliable estimates of air flow variability, and monitoring airflow variability by PEF requires good compliance.[2] Compliance and accuracy are challenging in home spirometry,[3] but may be improved using electronic peak flow meters.[4]

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