November 15, 2013

BALTIMORE, Maryland — Sensor-equipped inhalers that record every time asthma patients use their rescue medication can allow remote monitoring by physicians and may improve disease control and reduce healthcare costs, according to the interim results of a randomized controlled trial.

Despite treatment guidelines from the National Asthma Education and Prevention Program, most asthma is poorly controlled, largely because symptoms are intermittent and not easily recognized by patients, making prompt treatment adjustments difficult for physicians, said Rajan Merchant, MD, from the Woodland Clinic Medical Group in California.

“Remote monitoring allows physicians to see if there’s a change in their patient’s symptoms based on their bronchodilator use and that enables us to make adjustments to their treatment prior to them having to go to the emergency room,” he toldMedscape Medical News. “It can flag those with active symptoms versus those who are doing well and don’t need to come in unnecessarily, making management more efficient.”

Dr. Merchant presented the interim findings here at the American College of Allergy, Asthma & Immunology (ACAAI) 2013 Annual Scientific Meeting.

The study enrolled 502 patients with asthma, who all received electronic sensors attached to their bronchodilators for 1 year.

Remote monitoring allows physicians to see if there’s a change in their patient’s symptoms based on their bronchodilator use.Dr. Rajan Merchant

At baseline there were no significant differences between the intervention and control groups in terms of patient age, language, public rather than private insurance, and adult or child Asthma Control Test scores.

For patients randomly assigned to the intervention group, investigators recorded bronchodilator use by the sensors, which were then synced to their smartphones. The data could be accessed by the patients but were also transmitted to a server that allowed real-time monitoring by physicians. Automatic text or email alerts could be sent to both physicians and patients about any increase in bronchodilator use.

“When there was an increase, signaling a worsening of status, an alert went to the physician who made a decision about what to do, whether it was a phone call, an office visit, or additional meds,” said Dr. Merchant.

“There was also a component of patient education and self-management because a good number of patients were able to self-correct or self-manage when they got some of these alerts,” he added.

Patients in the control group also had the sensors, but their data were available only to the study investigators and did not influence their management.

At 4 months, interim results showed that the mean number of bronchodilator doses was similar in both groups, and overall asthma control had improved similarly.


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