Internet-based home asthma telemonitoring - Can patients handle the technology?

Study objectice: To evaluate the validity of spirometry self-testing during home telemonitoring and to assess the acceptance of an Internet-based home asthma telemonitoring system by asthma patients. Design: We studied an Internet-based telemonitoring system that collected spirometry. data and symptom reports from asthma patients' homes for review by physicians in the medical center's clinical information system. After a 40-min training session, patients completed an electronic diary and performed spirometry testing twice daily on their own from their homes for 3 weeks. A medical professional visited each patient by the end of the third neck of monitoring, 10 to 40 min after the patient had performed self-testing, and asked the patient to perform the spirometry test again under his supervision, We evaluated the validity of self-testing and surveyed the patients attitude toward the technology using a standardized questionnaire, Setting: Telemonitoring was conducted in patients' homes in a low-income inner city area, Patients: Thirty-one consecutive asthma patients without regard to computer experience. Measurement and results: Thirty-one asthma patients completed 3 weeks of monitoring, A paired t test showed no difference between unsupervised and supervised home spirometry self-testing, The variability of FVC (4.1%), FEV1, (3.7%), peak expiratory flow (7.9%), and other spirometric indexes in our study was similar to the within-subject variability reported by other researchers. Despite the fact that the majority of the patients (71%) had no computer experience, they indicated that the self-testing was "not complicated at all" or only "slightly complicated." The majority of patients (87.1%) were strongly interested in using home asthma telemonitoring in the future. Conclusions: Spirometry self-testing by asthma patients during telemonitoring is valid and comparable to those tests collected under the supervision of a trained medical professional, Internet-based home asthma telemonitoring can be successfully implemented in a group of patients with no computer background.