Finkelstein J, O'Connor G, Friedmann R H
Medical Information Systems Unit, Boston University, Boston, MA 02118, USA.
Stud Health Technol Inform. 2001;84(Pt 1):810-4.
National Asthma Education and Prevention Program (NAEPP) suggests using asthma action plans for patient self-care. Recent studies reported that many asthma patients had difficulties in following action plans on a daily basis and had low compliance to medication regimens. The goal of our study was to design and evaluate the Home Asthma Telemonitoring (HAT) system aimed to help asthma patients to follow their self-care plans according to the NAEPP recommendations. Our study resulted in the development of the system which provided patients with continuous individualized help in the daily routine of asthma self-care and notified heath care providers if certain clinical conditions occurred. This allowed early recognition of potentially dangerous situations and timely intervention. The evaluation of the HAT system underwent several stages. First we showed, that the HAT system provides reliable reciprocal exchange of all relevant information between a physician and asthma patient in home settings. Further evaluation demonstrated that lung function test results collected during home asthma telemonitoring are comparable to those collected under the supervision of trained professionals, and Internet-based home asthma telemonitoring can be successfully implemented in a group of patients without previous computer experience. Preliminary results of an on-going HAT evaluation showed higher patient compliance to asthma action plans in comparison to the compliance reported for patients in standard care. The clinical impact of HAT on asthma outcomes is being currently evaluated in a randomized clinical trial funded by NIH. HAT has a potential for improving clinical outcomes and quality of life in the studied patient population and may be a model for monitoring and self-management of patients with other chronic health conditions.
国家哮喘教育与预防计划(NAEPP)建议使用哮喘行动计划进行患者自我护理。最近的研究报告称,许多哮喘患者在日常遵循行动计划方面存在困难,对药物治疗方案的依从性较低。我们研究的目的是设计并评估家庭哮喘远程监测(HAT)系统,旨在帮助哮喘患者根据NAEPP的建议遵循自我护理计划。我们的研究促成了该系统的开发,该系统在哮喘自我护理的日常工作中为患者提供持续的个性化帮助,并在某些临床情况出现时通知医疗保健提供者。这有助于早期识别潜在的危险情况并及时进行干预。HAT系统的评估经历了几个阶段。首先,我们证明了HAT系统在家庭环境中能在医生和哮喘患者之间提供所有相关信息的可靠双向交换。进一步的评估表明,在家中进行哮喘远程监测期间收集的肺功能测试结果与在训练有素的专业人员监督下收集的结果相当,并且基于互联网的家庭哮喘远程监测可以在一组没有计算机经验的患者中成功实施。正在进行的HAT评估的初步结果显示,与标准护理患者报告的依从性相比,患者对哮喘行动计划的依从性更高。HAT对哮喘结局的临床影响目前正在由美国国立卫生研究院资助的一项随机临床试验中进行评估。HAT有潜力改善所研究患者群体的临床结局和生活质量,并且可能成为其他慢性健康状况患者监测和自我管理的模式。