The effectiveness of nurse-led telemonitoring of asthma: results of a randomized controlled trial

• Published in: Journal of evaluation in clinical practice 2008-08, Vol.14 (4), p.600-609
• Main Authors: Willems, Daniëlle C. M., Joore, Manuela A., Hendriks, Johannes J. E., Nieman, Fred H. M., Severens, Johan L., Wouters, Emiel F. M.
• Format: Article
• Language: English
• Subjects: Adolescent; Adult; asthma; Asthma - nursing; Asthma - therapy; Child; Female; Health Services - utilization; Humans; Male; medical consumption; Middle Aged; Quality of Life; Respiratory Function Tests; self-management; symptoms; Telemedicine - organization & administration; telemonitoring; Time Factors; Treatment Outcome; Young Adult
• ISSN: 1356-1294; 1365-2753
• DOI: 10.1111/j.1365-2753.2007.00936.x

Rationale, aims and objectives  The aim of the study was to evaluate the effects on, and the relationship between, asthma symptoms, asthma‐specific quality of life and medical consumption of a nurse‐led telemonitoring intervention compared with regular care in asthma in the Netherlands. Methods  One hundred and nine asthmatic outpatients (56 children; 53 adults) were randomly assigned to the treatment arms (12‐month follow‐up). The control group received regular outpatient care, while the intervention group used an asthma monitor with modem at home with an asthma nurse as the main caregiver. Clinical asthma symptoms and medical consumption were measured by using diaries. Asthma‐specific quality of life was measured by the (Paediatric) Asthma Quality of Life Questionnaire. Results  The study population generally represented mild to moderate asthmatics. The results show improvement in follow‐up, but no statistically significant difference between the groups was observed. Moderate to high correlations were found within the outcome parameters, but the most remarkable was the low and statistically significant correlation between asthma‐specific quality of life (daily functioning) and the self‐reported beta‐2 agonists. Conclusion  Overall, the telemonitoring programme evaluated in this study did not significantly decrease asthma symptoms or medical consumption, or improve asthma‐specific quality of life. The results showed that a telemonitoring programme on its own is not a guarantee of success. The patients' perception of asthma‐specific quality of life (daily functioning) should be a key element in asthma telemonitoring programmes.