HOSPITALIZATION REDUCTION BY AN ASTHMA TELE-MEDICINE SYSTEM

DOI 1 Citations 20 References
  • Kokubu Fumio
    First Department of Internal Medicine, School of Medicine, Showa University
  • Nakajima Shigenori
    Life Science Institute, Kinki University, School of Medicine
  • Ito Kouji
    Doai Memorial Hospital
  • Makino Souhei
    Tokyo Allergy Disease Research Institute
  • Kitamura Satoshi
    Department of Pulmonary Medicine, Jichi Medical School
  • Fukuchi Yoshinosuke
    Department of Chest Medicine, Juntendo University
  • Mano Kenji
    Department of Internal Medicine, Teikyo University, School of Medicine
  • Sano Yasuyuki
    Department of Allergy and Pulmonology, Doai Memorial Hospital
  • Inoue Hiroshi
    Allergy and Pulmonology Department, The 3rd Department of Internal Medicine, Iwate Medical University, School of Medicine
  • Morita Yutaka
    Department of Pulmonary Medicine, Faculty of Medicine, University of Tokyo
  • Fukuda Ken
    Department of Pulmonary Medicine and Clinical Immulology, Dokkyo University, School of Medicine
  • Akiyama Kazuo
    Clinical Research Institute, National Sagamihara Hospital
  • Adachi Mitsuru
    First Department of Internal Medicine, School of Medicine, Showa University
  • Miyamoto Terumasa
    Japan Clinical Allergy Research Institute

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Other Title
  • 喘息テレメディスンシステムによる入院の回避

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Abstract

We examined an effectiveness of a new asthma telemedicine system in reducing hospitalizations using a multi-site randomized control study. In this program, a nurse under physician supervision monitors the patient's airway status at home and provides instructions to individuals via the telephone, helping them manage exacerbations as well as reinforcing proper use of a zone-controlled management plan. Patients with a high risk for hospitalization were screened based on the numbers of emergency room visits and hopsitalizations found in a previous study and randomly assigned to either and telemedicine or control group. After a six-month study period, an 83% reduction in hospitalization was demonstrated in the telemedicine group versus the control group, with a P value of 0.01. Improvement of peak expiratory flow and symptoms were also shown in the study group. We conclude that the key success factors in home asthma management for poorly controlled asthma patients are early detection of exacerbations through daily peak flow monitoring, compliance with prescribed daily prophylactic anti-inflammatory steroid medications, and immediate action as specified by a zone-controlled action plan upon the first signs of deterioration.

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