Asthma Clinical Trial
Official title:
Telespirometry: Home Monitoring of Asthmatic Patients With Spirometer
Asthma is the most common respiratory disorder in children that causes breathing problems.
The patients may have respiratory symptoms such as cough, wheeze, or short of breath. Asthma
can be mild or severe when daily activities become compromised. Generally, by application of
proper treatment, asthma symptoms can be well controlled. However, the exacerbation of the
disease often leads to acute respiratory adverse events that require hospitalization and
school absenteeism.
In this study, we plan the remote monitoring of lung function parameters in asthmatic
children (under 18 years of age). We hypothesize that the daily home monitoring of
respiratory indices will predict the occurrence of exacerbation and the hospitalization can
be lowered.
Asthmatic children arriving for the regular examinations to the Department of Pediatrics and
Pediatric Health Care Center of the University of Szeged will be involved. The patients are
randomly divided into two treatment groups, telemonitoring and control.
For both groups, general patient characteristics will be recorded, and lung function
parameters will be measured with a clinical spirometer.
Patients in the telemedicine group receive the home mobile controlled spirometer and trained
by a pediatric pulmonologist for home examination. The spirometers are handed for 12 months,
and children are asked to perform measurements minimum 4 times per week (at least one day a
week in the morning and in the evening). In the case of asthma attacks, more frequent
measurements repeated several times a day are required. Children in the telemedicine group
complete the Asthma Control Test (ACT) after each measurement, which provides a numerical
score related to the severity of asthma symptoms. Lung function parameters measured by
children and the ACT results are automatically uploaded to a clinical server where the
pulmonologists and built-in algorithms are monitoring the quality of the data. In case of
deterioration of the lung function parameters, the patients are called for a personal visit
and their treatment can be revised.
Every three months, members of both groups come to the outpatient clinic for a personal
visit, where the same examinations are performed.
Asthma is the most common respiratory disorder in children characterized by periodic airway
obstruction, bronchial hyper-responsiveness, and airway inflammation. The symptoms of asthma
may include cough, wheeze, or bronchoconstriction with airflow limitation. The severity of
asthma may vary from mild to severe. Mild asthma is associated with rear events of short of
breath. However, the exacerbation of the disease often leads to acute respiratory adverse
events with severe hypoxia that requires hospitalization. The hospital care involves travel
costs for the children and parents, school and work absenteeism.
The primary objective of the study is to investigate whether the annual occurrence of asthma
exacerbation can be decreased by the use of the telespirometry system. Another objective is
to determine which lung function parameters are best to predict asthma exacerbation.
To address these aims we plan to involve two groups (telemonitoring and control) of asthmatic
children with GINA 2-5 stage under 18 years of age. Poor general condition, any disease which
endangers the health of the volunteer or contraindicates the study and lack of parental
consent are defined as the exclusion criteria.
The lung function in the children in both groups will be monitored by conventional
spirometric assessment performed at the Department of Pediatrics and Pediatric Health Care
Center of the University of Szeged. After each lung function assessments children will be
asked to fill the Asthma Control Test (ACT).
Patients in the telemedicine group receive the home mobile controlled spirometer and trained
by a pediatric pulmonologist for home examination. The spirometers are handed for 12 months,
and children are asked to perform measurements minimum 4 times per week (at least one day a
week in the morning and in the evening). In the case of asthma exacerbation, more frequent
measurements repeated several times a day are required. Children in the telemedicine group
complete the ACT after each measurement, which provides a numerical score related to the
severity of asthma symptoms. Lung function parameters measured by children and the ACT test
results are automatically uploaded to a clinical server where the pulmonologists and built-in
algorithms are monitoring the quality of the data. In case of deterioration of the lung
function parameters, the patients are called for a personal visit and their treatment can be
revised.
Every three months, members of both groups come to the outpatient clinic for a personal
visit, where the same examinations are performed.
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