Navigation Links
Internet monitoring strategy for severe asthma patients shown to be effective

ATS 2010, NEW ORLEANS Patients with severe asthma who use an internet-supported strategy and daily monitoring of exhaled nitric oxide (FENO) were able to control their asthma with lower overall dosing of oral corticosteroids (OCS) than patients who underwent usual care, according to research from the Netherlands.

"We know that in patients with prednisone-dependent asthma it is important to adjust the daily dose of oral corticosteroids to the lowest possible level in order to reduce long-term side effects," said Simone Hashimoto, M.D., research fellow from the department of respiratory medicine of the University of Amsterdam. "Our study shows that a novel internet-supported strategy including daily measurements of an objective marker of airway inflammation, FENO, and supervision by an asthma nurse allows frequent adjustments of prednisone dose, and leads to significant reduction of total corticosteroid consumption over a six months study period, as compared with patients receiving usual care. This was not accompanied by deterioration of asthma control or asthma-related quality of life."

The findings were presented at the ATS 2010 International Conference in New Orleans.

People with chronic health conditions, such as severe asthma, require continuous medical supervision, which can often be a logistical challenge, not only for overburdened healthcare systems, but for patients themselves, who may not have the time or flexibility to keep frequent appointments. "Internet monitoring allows centralized continuous long-distance support of patients, which can improve the quality of care, reduce the hazards associated with oral corticosteroids tapering, and can prevent drug-induced morbidity and mortality," explained Dr. Hashimoto.

While it was known that in patients with milder asthma, such programs had shown success, patients with severe asthma had yet been studied.

"Some patients with severe asthma require frequent bursts or even daily use of oral corticosteroids despite treatment with high dose of inhaled asthma medication. This leads to serious long-term adverse effects such as diabetes, blood hypertension, depression and osteoporosis, that may critically affect patients' quality of life and have considerable public health implications," explained Dr. Hashimoto. "Since adverse effects are dose and time dependent, corticosteroids should always be used in the lowest possible dose. In current practice, oral corticosteroid dose adjustments are made periodically by the patient's physician, based on subjective symptoms and signs, and not by objective parameters."

Dr. Hashimoto and colleagues designed a prospective, randomized, parallel, multicenter study with 89 patients with severe asthma study to test the hypothesis that a new internet-based strategy including daily home monitoring of symptoms, lung function, FENO, and regular feedback by an internet asthma nurse, would lead to a significant reduction of corticosteroid consumption without worsening of asthma control or asthma-related quality of life. In total, 89 patients were randomized to two tapering strategies: usual care, or internet-supported with daily monitoring of FENO, FEV1 and symptoms.

For those assigned to the internet-supported strategy, each patient had a password used to log in to a secure site where they recorded daily symptoms, lung function values, FENO value and dose of medicine that they took in the day. The values were controlled every day by a specialized asthma nurse and once a week patients received instructions about the dose of oral corticosteroids they should use. The process took about 5 minutes per day for the patient, and was well accepted. Patients could also contact the asthma nurse via the website or email in the event of questions or problems.

The researchers found that among patients assigned to the internet-supported strategy, cumulative 6-month dosing of OCS was significantly lower. "Of course, we hoped to find a positive result, because internet based self-management and management guidance by FENO has already been proven to be successful in adolescents with milder forms of asthma," said Dr. Hashimoto. "However, we were surprised that also in patients with severe prednisone-dependent asthma this strategy proved to be successful. These patients have years of continuous use of oral corticosteroids and a long history of attempts to taper their maintenance prednisone dose without success. This strategy gives them new hope that they can safely reduce the deleterious long-term side effects of prednisone."

"Our findings suggest that this novel internet-based strategy can and should be applied in all patients with severe prednisone dependent asthma to reduce total corticosteroid consumption. Internet technologies as well as biomarker driven therapies will become more and more common in future health care," Dr. Hashimoto concluded. "In the future, we will do more studies on a larger scale, to evaluate whether this strategy should be incorporated in guidelines for management of patients with severe asthma."


Contact: Keely Savoie
American Thoracic Society

Related medicine news :

1. Internet Addicts More Prone to Depression
2. Seota Clients See Large Increase in Internet Traffic and Revenue
3. Counterfeit Internet drugs pose significant risks and discourage vital health checks
4. 69-Year-Old Grandmother Needing A Lifesaving Kidney Transplant Finds a Miracle on the Internet: a 25-Year-Old Living Altruistic Organ Donor Stranger
5. Teen Internet Addicts More Likely to Self-Harm: Study
6. New Orleans Based Internet Marketing Is Helping Small Businesses Get a Chance to Shine On the Web
7. VHGI: VHGI Gold Targets Candidates to Fill Key Advisory Board Position to Evaluate International Mining Acquisitions; Internet Town Hall Meeting Details Emerge, Kitco Gold Coverage Initiated
8. LMU Expert: Avatar Could Be Game-Changer for Internet
9. Breastfeeding Boutique Offering Lactation Consultations Over the Internet
10. Donate a Herbal Natural Sleep Aid to the Internet's First "Natural Sleep Aids E-book" Written by People Just Like You
11. New Report: The Internet Has More Influence Over Consumer Health Actions than Traditional DTC Channels
Post Your Comments:
(Date:11/25/2015)... ... ... On November 23rd 2015 Cozy Products, a division of Bird-X ... Products explains what this means for business moving forward. , The Tri Lite heater ... model: to sell personal heaters that reduce energy consumption, are economical and keep people ...
(Date:11/25/2015)... ... November 25, 2015 , ... SCOTTSDALE, AZ) ... plastic surgeon specializing in both surgical and non-surgical treatments, announced the expansion of ... Hobgood Facial Plastic Surgery. , Highly trained and nationally recognized for his ...
(Date:11/25/2015)... ... November 25, 2015 , ... Brillianteen, McGaw ... and learning in its 65th Anniversary Brillianteen Revue, scheduled for March 4-6, 2016. ... For 65 years, Brillianteen has been a treasured tradition for numerous families in ...
(Date:11/25/2015)... ... , ... “While riding the bus, I saw a passenger in a wheelchair ... to be a convenient and comfortable way to protect them from bad weather, so ... safely travel during cold or inclement weather. In doing so, it ensures that the ...
(Date:11/25/2015)... Missouri (PRWEB) , ... November 25, 2015 , ... ... HEAL, will provide scholarships for people struggling with eating disorders as a result ... from the second annual event, held at Fox Run Golf Club in Eureka, ...
Breaking Medicine News(10 mins):
(Date:11/25/2015)... , Nov. 25, 2015 AAIPharma ... planned investment of at least $15.8  Million to ... Wilmington, NC . The expansion will ... to meet the growing demands of the pharmaceutical ... site expansion will provide up to 40,000 ...
(Date:11/25/2015)... Allergan plc (NYSE: AGN ) today announced that it ... State Attorney General,s Office to end the litigation ... with the Attorney General over the decision of Forest Laboratories, ... the now generic version of memantine immediate release tablets.  Under ... its counterclaims against New York , and ...
(Date:11/25/2015)... USP 800 applies to all healthcare ... pharmacy technicians, nurses, physicians, physician assistants, home healthcare ... covers all entities which store, prepare, transport, or ... institutions, patient treatment clinics, physicians, practice facilities, and ... --> What is the purpose of USP ...
Breaking Medicine Technology: