Improving asthma control through telemedicine: A study of short-message service
Improving asthma control through telemedicine: A study of short-message service
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DOI：
10.1089/tmj.2005.11.28
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发表时间：
2005-02-01
期刊：
影响因子：
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通讯作者：
Tudjman, Z
中科院分区：
文献类型：
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作者：
Ostojic, V;Cvoriscec, B;Tudjman, Z
哮喘指南推荐家庭峰值呼气流量（PEF）测量。在一项为期16周的随机对照研究中，有6名哮喘受试者（24.6 ± 6.5岁，哮喘持续时间。6个月），我们研究了全球移动的通信系统（GSM）移动的电话短消息服务（SMS）作为PEF监测中远程医疗的新手段。所有受试者均接受哮喘教育、自我管理计划和标准治疗。所有患者每天测量三次PEF，并记录症状日记。在研究组中，由哮喘专家根据每天从患者处获得的PEF值每周调整治疗。两组之间的绝对PEF无显著差异，但研究组的PEF变异性显著较小（16.12 +/- 6.93% vs. 27.24 +/-10.01%，p = 0.049）。1秒用力呼气流量研究组的FEV 1（%预测值）轻微但显著增加（81.25 +/- 17.31 vs. 77.63 +/- 14.80，p = 0.014），对照组无变化（78.25 +/- 21.09 vs. 78.88 +/- 22.02，p = 0.497）。研究前后两组的平均FEV 1相似。对照组的咳嗽评分（1.85 +/- 0.43 vs. 1.42 +/- 0.28，p < 0.05）和夜间症状评分（1.22 +/- 0.23 vs. 0.85 +/- 0.32，p < 0.05）显著更高。两组在每日吸入药物消耗量、用力肺活量或依从性方面没有显著差异。每名患者每周通过短信随访的额外费用为1. 67欧元（相当于每1欧元约1. 30美元），短信传输需要11. 5分钟。虽然随访研究需要40例患者的研究组，以在95%置信区间内达到80%的功效，但我们得出结论，SMS是一种方便、可靠、负担得起和安全的远程医疗手段，当添加到书面行动计划和标准随访中时，可以改善哮喘控制。
Home peak expiratory flow ( PEF) measurement is recommended by asthma guidelines. In a 16-week randomized controlled study on there exists 6 subjects with asthma ( 24.6 +/- 6.5 years old, asthma duration. 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 A E1.67 ( 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.