Internet-based home asthma telemonitoring: Can patients handle the technology?

Joseph Finkelstein, Manuel R. Cabrera, George Hripcsak

Research output: Contribution to journalArticle

Abstract

Study objective: To evaluate the validity of spirometry self-testing during home telemonitoring and to assess the acceptance of an Internet-based home asthma telemonitoring system by asthma patients. Design: We studied an Internet-based telemonitoring system that collected spirometry data and symptom reports from asthma patients' homes for review by physicians in the medical center's clinical information system. After a 40-min training session, patients completed an electronic diary and performed spirometry testing twice daily on their own from their homes for 3 weeks. A medical professional visited each patient by the end of the third week of monitoring, 10 to 40 rain after the patient had performed self-testing, and asked the patient to perform the spirometry test again under his supervision. We evaluated the validity of self-testing and surveyed the patients attitude toward the technology using a standardized questionnaire. Setting: Telemonitoring was conducted in patients' homes in a low-income inner city area. Patients: Thirty-one consecutive asthma patients without regard to computer experience. Measurement and results: Thirty-one asthma patients completed 3 weeks of monitoring. A paired t test showed no difference between unsupervised and supervised home spirometry self-testing. The variability of FVC (4.1%), FEV1 (3.7%), peak expiratory flow (7.9%), and other spirometric indexes in our study was similar to the within-subject variability reported by other researchers. Despite the fact that the majority of the patients (71%) had no computer experience, they indicated that the self-testing was 'not complicated at all' or only 'slightly complicated'. The majority of patients (87.1%) were strongly interested in using home asthma telemonitoring in the future. Conclusions: Spirometry self-testing by asthma patients during telemonitoring is valid and comparable to those tests collected under the supervision of a trained medical professional. Internet-based home asthma telemonitoring can be successfully implemented in a group of patients with no computer background.

Original languageEnglish (US)
Pages (from-to)148-155
Number of pages8
JournalCHEST
Volume117
Issue number1
DOIs
StatePublished - Jan 1 2000

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Keywords

  • Asthma
  • Peak expiratory flow
  • Self-management
  • Spirometry
  • Telemonitoring

ASJC Scopus subject areas

  • Pulmonary and Respiratory Medicine
  • Critical Care and Intensive Care Medicine
  • Cardiology and Cardiovascular Medicine

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