Only then will telemonitoring achieve the aim of preventing hospital admissions , contributing to the reduction of health re source utilization and improving the quality of life of patients
Major reported factors associated with the limited effectiveness of home telemonitoring interventions in chronic respiratory conditions include the lack of useful early predictors , poor patient compliance and the poor performance of conventional algorithms for detecting deteriorations .
This article provides a systematic review of existing algorithms and the factors associated with their performance in detecting exacerbations and supporting clinical decisions in patients with chronic obstructive pulmonary disease ( COPD ) or asthma .
Quadrupling the dose of inhaled corticosteroid to prevent asthma exacerbations: a randomized, double-blind, placebo-controlled, parallel-group clinical trial.
RATIONALE Asthma exacerbations are unpredictable , disruptive , and frightening , and are therefore important to prevent . OBJECTIVES We investigated whether a policy of quadrupling the dose of inhaled corticosteroid when asthma control starts to deteriorate reduces asthma exacerbations requiring treatment with oral corticosteroids . METHODS A total of 403 people with asthma were given a self-management plan and r and omized to take an active or placebo corticosteroid inhaler in addition to their usual asthma treatment when their PEF fell by 15 % on 2 consecutive days or by 30 % on 1 day . The study inhalers provided a quadrupling or no change in corticosteroid dose . MEASUREMENTS AND MAIN RESULTS Eighteen of 197 ( 9 % ) and 29 of 203 ( 14 % ) participants had an exacerbation of asthma requiring treatment with oral corticosteroids  in the active and placebo groups , respectively , giving a risk ratio of 0.64 ( 95 % confidence interval , 0.37 - 1.11 , P = 0.11 ) . Of the 94 participants who started the study inhaler far fewer required treatment with oral corticosteroids in the active compared with the placebo group : 12 of 56 ( 21 % ) in the active group and 19 of 38 ( 50 % ) in the placebo group , giving a risk ratio of 0.43 ( 95 % confidence interval , 0.24 - 0.78 , P = 0.004 ) . CONCLUSIONS Although our primary outcome did not reach statistical significance , quadrupling the dose of inhaled corticosteroid when asthma control starts to deteriorate appears to reduce acute exacerbations of asthma and deserves further investigation . Clinical trial registered with www.controlled-trials.com ( IS RCT N 46018181 )
Only then will telemonitoring achieve the aim of preventing hospital admissions , contributing to the reduction of health re source utilization and improving the quality of life of patients
Major reported factors associated with the limited effectiveness of home telemonitoring interventions in chronic respiratory conditions include the lack of useful early predictors , poor patient compliance and the poor performance of conventional algorithms for detecting deteriorations .
This article provides a systematic review of existing algorithms and the factors associated with their performance in detecting exacerbations and supporting clinical decisions in patients with chronic obstructive pulmonary disease ( COPD ) or asthma .