Forum for Science, Industry and Business

Sponsored by:     3M 
Search our Site:

 

Internet monitoring strategy for severe asthma patients shown to be effective

17.05.2010
Patients with severe asthma who use an internet-supported strategy and daily monitoring of exhaled nitric oxide (FENO) were able to control their asthma with lower overall dosing of oral corticosteroids (OCS) than patients who underwent usual care, according to research from the Netherlands.

"We know that in patients with prednisone-dependent asthma it is important to adjust the daily dose of oral corticosteroids to the lowest possible level in order to reduce long-term side effects," said Simone Hashimoto, M.D., research fellow from the department of respiratory medicine of the University of Amsterdam.

"Our study shows that a novel internet-supported strategy including daily measurements of an objective marker of airway inflammation, FENO, and supervision by an asthma nurse allows frequent adjustments of prednisone dose, and leads to significant reduction of total corticosteroid consumption over a six months study period, as compared with patients receiving usual care. This was not accompanied by deterioration of asthma control or asthma-related quality of life."

The findings were presented at the ATS 2010 International Conference in New Orleans.

People with chronic health conditions, such as severe asthma, require continuous medical supervision, which can often be a logistical challenge, not only for overburdened healthcare systems, but for patients themselves, who may not have the time or flexibility to keep frequent appointments. "Internet monitoring allows centralized continuous long-distance support of patients, which can improve the quality of care, reduce the hazards associated with oral corticosteroids tapering, and can prevent drug-induced morbidity and mortality," explained Dr. Hashimoto.

While it was known that in patients with milder asthma, such programs had shown success, patients with severe asthma had yet been studied.

"Some patients with severe asthma require frequent bursts or even daily use of oral corticosteroids despite treatment with high dose of inhaled asthma medication. This leads to serious long-term adverse effects such as diabetes, blood hypertension, depression and osteoporosis, that may critically affect patients' quality of life and have considerable public health implications," explained Dr. Hashimoto. "Since adverse effects are dose and time dependent, corticosteroids should always be used in the lowest possible dose. In current practice, oral corticosteroid dose adjustments are made periodically by the patient's physician, based on subjective symptoms and signs, and not by objective parameters."

Dr. Hashimoto and colleagues designed a prospective, randomized, parallel, multicenter study with 89 patients with severe asthma study to test the hypothesis that a new internet-based strategy including daily home monitoring of symptoms, lung function, FENO, and regular feedback by an internet asthma nurse, would lead to a significant reduction of corticosteroid consumption without worsening of asthma control or asthma-related quality of life. In total, 89 patients were randomized to two tapering strategies: usual care, or internet-supported with daily monitoring of FENO, FEV1 and symptoms.

For those assigned to the internet-supported strategy, each patient had a password used to log in to a secure site where they recorded daily symptoms, lung function values, FENO value and dose of medicine that they took in the day. The values were controlled every day by a specialized asthma nurse and once a week patients received instructions about the dose of oral corticosteroids they should use. The process took about 5 minutes per day for the patient, and was well accepted. Patients could also contact the asthma nurse via the website or email in the event of questions or problems.

The researchers found that among patients assigned to the internet-supported strategy, cumulative 6-month dosing of OCS was significantly lower. "Of course, we hoped to find a positive result, because internet based self-management and management guidance by FENO has already been proven to be successful in adolescents with milder forms of asthma," said Dr. Hashimoto. "However, we were surprised that also in patients with severe prednisone-dependent asthma this strategy proved to be successful. These patients have years of continuous use of oral corticosteroids and a long history of attempts to taper their maintenance prednisone dose without success. This strategy gives them new hope that they can safely reduce the deleterious long-term side effects of prednisone."

"Our findings suggest that this novel internet-based strategy can and should be applied in all patients with severe prednisone dependent asthma to reduce total corticosteroid consumption. Internet technologies as well as biomarker driven therapies will become more and more common in future health care," Dr. Hashimoto concluded. "In the future, we will do more studies on a larger scale, to evaluate whether this strategy should be incorporated in guidelines for management of patients with severe asthma."

"Monitoring Exhaled Nitric Oxide (FENO) to Tailor the Lowest Effective Dose of Oral Corticosteroids in Sever Asthma (MONOSA- Study)" (Session B92, Monday, May 17, 1:30- 4:00 p.m., CC-Room 228-230 (Second Level), Morial Convention Center; Abstract 492)

Keely Savoie | EurekAlert!
Further information:
http://www.thoracic.org

More articles from Health and Medicine:

nachricht A promising target for kidney fibrosis
21.04.2017 | Brigham and Women's Hospital

nachricht Stem cell transplants: activating signal paths may protect from graft-versus-host disease
20.04.2017 | Technische Universität München

All articles from Health and Medicine >>>

The most recent press releases about innovation >>>

Die letzten 5 Focus-News des innovations-reports im Überblick:

Im Focus: Deep inside Galaxy M87

The nearby, giant radio galaxy M87 hosts a supermassive black hole (BH) and is well-known for its bright jet dominating the spectrum over ten orders of magnitude in frequency. Due to its proximity, jet prominence, and the large black hole mass, M87 is the best laboratory for investigating the formation, acceleration, and collimation of relativistic jets. A research team led by Silke Britzen from the Max Planck Institute for Radio Astronomy in Bonn, Germany, has found strong indication for turbulent processes connecting the accretion disk and the jet of that galaxy providing insights into the longstanding problem of the origin of astrophysical jets.

Supermassive black holes form some of the most enigmatic phenomena in astrophysics. Their enormous energy output is supposed to be generated by the...

Im Focus: A Quantum Low Pass for Photons

Physicists in Garching observe novel quantum effect that limits the number of emitted photons.

The probability to find a certain number of photons inside a laser pulse usually corresponds to a classical distribution of independent events, the so-called...

Im Focus: Microprocessors based on a layer of just three atoms

Microprocessors based on atomically thin materials hold the promise of the evolution of traditional processors as well as new applications in the field of flexible electronics. Now, a TU Wien research team led by Thomas Müller has made a breakthrough in this field as part of an ongoing research project.

Two-dimensional materials, or 2D materials for short, are extremely versatile, although – or often more precisely because – they are made up of just one or a...

Im Focus: Quantum-physical Model System

Computer-assisted methods aid Heidelberg physicists in reproducing experiment with ultracold atoms

Two researchers at Heidelberg University have developed a model system that enables a better understanding of the processes in a quantum-physical experiment...

Im Focus: Glacier bacteria’s contribution to carbon cycling

Glaciers might seem rather inhospitable environments. However, they are home to a diverse and vibrant microbial community. It’s becoming increasingly clear that they play a bigger role in the carbon cycle than previously thought.

A new study, now published in the journal Nature Geoscience, shows how microbial communities in melting glaciers contribute to the Earth’s carbon cycle, a...

All Focus news of the innovation-report >>>

Anzeige

Anzeige

Event News

Expert meeting “Health Business Connect” will connect international medical technology companies

20.04.2017 | Event News

Wenn der Computer das Gehirn austrickst

18.04.2017 | Event News

7th International Conference on Crystalline Silicon Photovoltaics in Freiburg on April 3-5, 2017

03.04.2017 | Event News

 
Latest News

New quantum liquid crystals may play role in future of computers

21.04.2017 | Physics and Astronomy

A promising target for kidney fibrosis

21.04.2017 | Health and Medicine

Light rays from a supernova bent by the curvature of space-time around a galaxy

21.04.2017 | Physics and Astronomy

VideoLinks
B2B-VideoLinks
More VideoLinks >>>