+1 Recommend
2 collections
      • Record: found
      • Abstract: found
      • Article: found
      Is Open Access

      Remote Patient Monitoring Effectively Assures Continuity of Care in Asthma Patients during the COVID-19 Pandemic


      Read this article at

          There is no author summary for this article yet. Authors can add summaries to their articles on ScienceOpen to make them more accessible to a non-specialist audience.



          Digital health tools to bridge gaps in managing infectious pandemics was a proposition grounded, until recently, more hypothetically than in reality. The last 2 years exposed the extraordinary global need for robust digital solutions.


          Determine the ability of remote patient monitoring (RPM) during the COVID-19 (coronavirus disease) pandemic to improve clinical outcomes and assure continuity of care in patients with asthma.


          A total of 102 patients with asthma were enrolled in a telemonitoring protocol at the beginning of the COVID-19 pandemic in the United States. Intervention combined health coaching telephone calls and remote telemonitoring at a private, university-affiliated, outpatient clinical adult, and pediatric allergy/immunology and pulmonary practice. Patients enrolled with the primary rationale of maintaining continuity of care in the face of uncertain clinical care options. Enrollment and data collection proceeded in a fashion to allow detailed retrospective analysis. Telemonitoring included a pulse oximeter linked to a smartphone using the software platform Plan-it Med (PIM) ®. A healthcare professional monitored data daily, and patients were contacted by providers due to vital sign abnormalities and treatment plan alterations. Patients were encouraged to remain on the platform daily during the first 3 months of the pandemic. After respiratory and/or clinical stability was achieved and clinic visit opportunities were resumed, patients were encouraged to maintain engagement with the platform but were not expected to use the platform daily. Asthma control test (ACT) scores were recorded before and after 6 months. Paired Wilcoxon signed-rank tests (dependent groups, before vs. after) and Wilcoxon rank-sum (Mann–Whitney) tests were performed for unpaired results (independent groups, RPM vs. control).


          Among 102 patients 19 had physiological abnormalities detected (18.6%). Eight of these 19 patients had actionable changes in prescription regimens based on RPM findings (42.1%). In patients utilizing RPM, there was a reported decrease in shortness of breath episodes and decreased need for rescue inhalers/nebulizer medications ( P = 0.005). Daily engagement in the first 3 months of the protocol was 61%. Subset analysis revealed 48 study participants (47.1%) chose to continue to actively use the program for at least 14 months. RPM patients ( n = 54) were 99.1% compliant with RPM after 110 patient months. Among patients who discontinued the RPM program, reasons included: 1) symptom alleviation (41.7%), 2) out-of-pocket costs to patients (38.9%), and 3) difficulty using the RPM program (16.7%).


          Telemedicine is a valuable adjunct to face-to-face visits for asthma care. A novel RPM technology positively impacted continuity of care, asthma outcomes, quality of life, and self-care. Remote therapeutic monitoring offers great promise as a diagnostic tool and therapeutic intervention to improve adherence for patients with difficult-to-control asthma.

          Related collections

          Most cited references36

          • Record: found
          • Abstract: found
          • Article: not found

          Wireless pulmonary artery haemodynamic monitoring in chronic heart failure: a randomised controlled trial.

          Results of previous studies support the hypothesis that implantable haemodynamic monitoring systems might reduce rates of hospitalisation in patients with heart failure. We undertook a single-blind trial to assess this approach. Patients with New York Heart Association (NYHA) class III heart failure, irrespective of the left ventricular ejection fraction, and a previous hospital admission for heart failure were enrolled in 64 centres in the USA. They were randomly assigned by use of a centralised electronic system to management with a wireless implantable haemodynamic monitoring (W-IHM) system (treatment group) or to a control group for at least 6 months. Only patients were masked to their assignment group. In the treatment group, clinicians used daily measurement of pulmonary artery pressures in addition to standard of care versus standard of care alone in the control group. The primary efficacy endpoint was the rate of heart-failure-related hospitalisations at 6 months. The safety endpoints assessed at 6 months were freedom from device-related or system-related complications (DSRC) and freedom from pressure-sensor failures. All analyses were by intention to treat. This trial is registered with ClinicalTrials.gov, number NCT00531661. In 6 months, 83 heart-failure-related hospitalisations were reported in the treatment group (n=270) compared with 120 in the control group (n=280; rate 0·31 vs 0·44, hazard ratio [HR] 0·70, 95% CI 0·60-0·84, p<0·0001). During the entire follow-up (mean 15 months [SD 7]), the treatment group had a 39% reduction in heart-failure-related hospitalisation compared with the control group (153 vs 253, HR 0·64, 95% CI 0·55-0·75; p<0·0001). Eight patients had DSRC and overall freedom from DSRC was 98·6% (97·3-99·4) compared with a prespecified performance criterion of 80% (p<0·0001); and overall freedom from pressure-sensor failures was 100% (99·3-100·0). Our results are consistent with, and extend, previous findings by definitively showing a significant and large reduction in hospitalisation for patients with NYHA class III heart failure who were managed with a wireless implantable haemodynamic monitoring system. The addition of information about pulmonary artery pressure to clinical signs and symptoms allows for improved heart failure management. CardioMEMS. Copyright © 2011 Elsevier Ltd. All rights reserved.
            • Record: found
            • Abstract: found
            • Article: not found

            Development of the asthma control test: a survey for assessing asthma control.

            Asthma guidelines indicate that the goal of treatment should be optimum asthma control. In a busy clinic practice with limited time and resources, there is need for a simple method for assessing asthma control with or without lung function testing. The objective of this article was to describe the development of the Asthma Control Test (ACT), a patient-based tool for identifying patients with poorly controlled asthma. A 22-item survey was administered to 471 patients with asthma in the offices of asthma specialists. The specialist's rating of asthma control after spirometry was also collected. Stepwise regression methods were used to select a subset of items that showed the greatest discriminant validity in relation to the specialist's rating of asthma control. Internal consistency reliability was computed, and discriminant validity tests were conducted for ACT scale scores. The performance of ACT was investigated by using logistic regression methods and receiver operating characteristic analyses. Five items were selected from regression analyses. The internal consistency reliability of the 5-item ACT scale was 0.84. ACT scale scores discriminated between groups of patients differing in the specialist's rating of asthma control (F = 34.5, P <.00001), the need for change in patient's therapy (F = 40.3, P <.00001), and percent predicted FEV(1) (F = 4.3, P =.0052). As a screening tool, the overall agreement between ACT and the specialist's rating ranged from 71% to 78% depending on the cut points used, and the area under the receiver operating characteristic curve was 0.77. Results reinforce the usefulness of a brief, easy to administer, patient-based index of asthma control.
              • Record: found
              • Abstract: found
              • Article: not found

              Applications of digital technology in COVID-19 pandemic planning and response

              Summary With high transmissibility and no effective vaccine or therapy, COVID-19 is now a global pandemic. Government-coordinated efforts across the globe have focused on containment and mitigation, with varying degrees of success. Countries that have maintained low COVID-19 per-capita mortality rates appear to share strategies that include early surveillance, testing, contact tracing, and strict quarantine. The scale of coordination and data management required for effective implementation of these strategies has—in most successful countries—relied on adopting digital technology and integrating it into policy and health care. This Viewpoint provides a framework for the application of digital technologies in pandemic management and response, highlighting ways in which successful countries have adopted these technologies for pandemic planning, surveillance, testing, contact tracing, quarantine, and health care.

                Author and article information

                Telehealth and Medicine Today
                Partners in Digital Health
                17 November 2022
                : 7
                : 10.30953/tmt.v7.374
                [1 ]Three Village Allergy and Immunology, South Setauket, New York
                [2 ]Department of Biomedical and Health Informatics, University of Missouri, Kansas City, Kansas City, Missouri, USA
                [3 ]Play-it Health, Inc., Overland Park, Kansas, USA
                [4 ]University of Illinois at Chicago, U.S. Department of Veterans Affairs, Chicago, Illinois
                [5 ]Stony Brook University, Stony Brook, New York, USA
                [6 ]Jefferson College of Population Health, Philadelphia, Pennsylvania, USA
                [7 ]Interdisciplinary Research Institute for Health Law and Science, Sigmund Freud University Vienna, Vienna, Austria
                [8 ]Zucker School of Medicine at Hofstra/Northwell; College of Engineering and Applied Sciences, Stony Brook University, Stony Brook, New York, USA
                Author notes
                [* ]Corresponding Author: Paul Barach, Email: paul.barach@ 123456jefferson.edu
                Author information
                © 2022 Christopher March et al.

                This is an open access article distributed in accordance with the Creative Commons Attribution Non-Commercial (CC BY-NC 4.0) license, which permits others to distribute, adapt, enhance this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial.

                : 03 October 2022
                : 10 October 2022
                : 18 October 2022
                ORIGINAL RESEARCH

                Social & Information networks,General medicine,General life sciences,Health & Social care,Public health,Hardware architecture
                remote patient monitoring,asthma,coronavirus disease,telehealth,COVID-19,quality


                Comment on this article