June 13, 2010 An online self-management tool for people with asthma has been shown to significantly improve their ability to reduce their symptoms. Researchers writing in the journal Respiratory Research tested the system in 200 adults with asthma, finding significant effects in those whose asthma was either partly controlled or uncontrolled at the beginning of the trial.
Victor van der Meer worked with a team of researchers from Leiden University Medical Centre, The Netherlands, to carry out the trial. He said, "The improvements in asthma control scores for patients with partly or uncontrolled asthma at baseline suggest a significant reduction of current asthma symptoms. Future asthma treatment strategies should incorporate continuous self-monitoring, as demonstrated here."
Participants in the researchers' system were trained to measure their own lung function and input the results, either by a web application or text message. The web site then suggests personalized advice on how to adjust treatment and presents a graphical representation of how they are progressing. According to van der Meer, "This asthma action plan is one of few that not only specifies action points to increase treatment but also to decrease it, which provides the possibility to tailor medication to individual needs. All control level groups showed a similar pattern of pharmacological therapy over time: an increase in inhaled corticosteroids in the first three months, followed by a decrease in the next 9 months."
Patients adhered to the system well, with around an 80% participation rate in the first three months, decreasing to 60% by the end of the trial. This reflects the reduced need for monitoring once control of the disease has been achieved.
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- Victor Van der Meer, Henk F Van Stel, Moira J Bakker, Albert C Roldaan, Willem JJ Assendelft, Peter J Sterk, Klaus F Rabe, Jacob K Sont and Smashing Study Group. Weekly self-monitoring and treatment adjustment benefit patients with partly controlled and uncontrolled asthma: an analysis of the SMASHING study. Respiratory Research, (in press) [link]
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