Background: The ability to perceive bronchial obstruction is
variable in asthma. This is one of the main causes of inaccurate asthma
control assessment, on which therapeutic strategies are based.
Objective: Primary: To evaluate the ability of a
clinical and spirometric telemonitoring device to characterize symptom
perception profile in asthmatic children. Secondary: To evaluate
its impact on asthma management (control, treatment, respiratory
function variability) and the acceptability of this telemonitoring
system. Method: 26 asthmatic children aged 6-18 years equipped
with a portable spirometer and a smartphone application were monitored
remotely for 3 months. Clinical and spirometric data were automatically
transmitted to a secure internet platform. A medical team contacted the
patient to optimize management. Three physicians blindly and
independently classified the patients according to their perception
profile. The impact of telemonitoring on the quantitative data was
assessed at the beginning (T0) and end (T3 months) of telemonitoring,
using matched statistical tests. Results: Patients could
initially be classified according to their perception profile, with a
concordance between the 3 observers of 64% (kappa coefficient: 0.55,
95%CI [0.39; 0.71]). After further discussion, a consensus was
reached and resulted in 97% concordance (kappa coefficient: 0.97,
95%CI [0.91; 1.00]). There was a trend towards improvement in the
ACT score, and a significant > 40% decrease in FEV1 and
PEF variability, with good acceptance of the device.
Conclusion: Clinical and spirometric telehome monitoring is
applicable and can help define the perception profile of bronchial
obstruction in asthmatic children. The device was generally well
accepted.
The Effect of Adding a Training Device and Smartphone Application to Traditional Verbal Counseling in Asthmatic Children
