Home monitoring of asthmatic patients with a novel transtelephonic spirometery system: A retrospective feasibility study to detect early signs of acute asthmatic deterioration

Purpose: During the last decade there is a real increase in asthma morbidity and mortality, as well as, in costly emergency room and hospital admissions. The aim of the present study is to assess the feasibility of telemedicine in patient home monitoring to detect early signs of acute asthmatic deterioration. Methods: Thirty nine patients, 23 with moderate and 16 with severe asthma, 18 males and 21 females, mean age 53 years (range: 12 to 77 years) were included in the study. Patients were monitored with a newly developed transtelephonic spirometer (SPIROPHONE AG-SP), Card Guard, Rishon Le Zion, Israel. The spirometric data (FVC, FEV₁, PEF, FEF₂₅, FEF₅₀, FEF₇₅) were transmitted from patient's home in real time to the monitoring center (N.T.L.T., Ramat-Gan, Israel), based on patient's judgment. In case of an acute respiratory distress, patients received standard emergency treatment at their home from a Mobile Intensive Care Unit (MICU). The spirometric data from all transmissions were analyzed to detect early signs of acute asthmatic deterioration that resulted in MICU dispatch. Results: In 13 patients, analysis of the spirometric data revealed early detection of deterioration that resulted in a dispatch of MICU. In 9 patients no deteriorations were detected by the analysis and no MICU was dispatched. In 11 patients (4 with severe and 7 with moderate asthma) no deteriorations were detected by analysis and MICU was dispatched. In 6 patients (all with moderate asthma) a deterioration was detected by the analysis and no MICU was dispatched. Conclusions: Analysis of spirometric data correlates with the decision making for MICU dispatch in 22 out of 39 (56%) patients. In these cases, early change in treatment may prevent the acute respiratory distress and MICU dispatch. In patients with severe asthma the decision of MICU dispatch can not be based on the analysis of the spirometric data alone. Clinical Implications: Home monitoring of asthmatic patients with the transtelephonic spirometer system, may improve the management of the disease and reduce costly hospitalizations.