Asthma management program by remote control monitoring of symptoms and peak expiratory flow rates

Purpose: To evaluate the clinical usefulness of the trans-telephone monitoring system of SHAHAL (an emergency medical service) for peak expiratory flow rates (PEFR) and symptoms in order to assist patients with bronchial asthma. Methods: Patients were classified according to disease severity, baseline pulmonary function, allergy status, and daily treatment. On-line PEFR and reports of symptoms were transmitted to a trained medical team which decided the proper management during an attack. Monthly (February - December 1994) data analysis was made on 34 patients (mean age 55±7 yrs) who used the system. Results: Twenty-two individuals were atopic, and 19 had severe, 12 had moderate and 3 had mild disease. Mean monthly calls dropped gradually but consistently and significantly, from 10.3 to 6 (p<0.05). A comparison of mean PEFR showed a significant rise in PEFR, with higher values in the second half of the year compared to the first half. There was a significant inverse correlation between number of calls and the PEFR values, each month and for the entire period (p<0.0001). Conclusion: Trans-telephonic monitoring of PEFR and symptoms improved these patients' quality of life and respiratory status. Clinical implications: The clinical status of asthmatic patients can be further improved by trans-telephonic monitoring.