Predicting asthma exacerbations employing remotely monitored adherence

Healthcare Technology Letters

article

Isabelle Killane¹  Imran Sulaiman¹  Elaine MacHale¹  Aoife Breathnach¹  Terence E. Taylor²  Martin S. Holmes²  Richard B. Reilly²  Richard W. Costello¹ 

[1] Clinical Research Centre, Beaumont Hospital, Royal College of Surgeons in Ireland;Trinity Centre for Bioengineering, School of Engineering, Trinity College, University of Dublin;School of Medicine, Trinity College, University of Dublin;Department of Medicine, Beaumont Hospital, Royal College of Surgeons in Ireland

关键词: diseases;    pneumodynamics;    decision support systems;    regression analysis;    Poisson distribution;    patient monitoring;    dose counter adherence;    body mass index;    gender;    age;    multivariate modified Poisson regression;    univariate modified Poisson regression;    remote monitoring adherence device;    inhaler medication;    multisite longitudinal randomised control trial;    respiratory medicine;    decision-support system;    asthma exacerbations;   

DOI  :  10.1049/htl.2015.0058

学科分类：肠胃与肝脏病学

来源: Wiley

【 摘 要 】

This Letter investigated the efficacy of a decision-support system, designed for respiratory medicine, at predicting asthma exacerbations in a multi-site longitudinal randomised control trial. Adherence to inhaler medication was acquired over 3 months from patients with asthma employing a dose counter and a remote monitoring adherence device which recorded participant's inhaler use: n = 184 (23,656 audio files), 61% women, age (mean ± sd) 49.3 ± 16.4. Data on occurrence of exacerbations was collected at three clinical visits, 1 month apart. The relative risk of an asthma exacerbation for those with good and poor adherence was examined employing a univariate and multivariate modified Poisson regression approach; adjusting for age, gender and body mass index. For all months dose counter adherence was significantly ( p < 0.01) higher than remote monitoring adherence. Overall, those with poor adherence had a 1.38 ± 0.34 and 1.42 ± 0.39 (remotely monitored) and 1.25 ± 0.32 and 1.18 ± 0.31 (dose counter) higher relative risk of an exacerbation in model 1 and model 2, respectively. However, this was not found to be statistically significantly different. Remotely monitored adherence holds important clinical information and future research should focus on refining adherence and exacerbation measures. Decision-support systems based on remote monitoring may enhance patient–physician communication, possibly reducing preventable adverse events.

【 授权许可】

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