The Effectiveness of An Interactive Electronic Lung Function Monitoring System in the Total Management of Refractory Asthma

A hand-held interactive electronic lung function device and tele-health monitoring system (AirWatch(TM) Airway Monitoring System, ENACT Health Management Systems, Inc., Mountain View, California, USA) has been developed that measures, records and reports airway status via a remote computer to the healthcare team of the patient with asthma. This article discusses the contribution of this electronic lung function monitoring system to a comprehensive programme of asthma care of 26 patients with severe asthma (mean age 48.7 +- 17.9 years) followed for a total of 359 patient-months. The total number of emergency room visits decreased from 84 (mean 3.32 +- 8.45 per patient) before beginning the treatment programme to 1 (mean 0.04 +- 0.20 per patient) after participating in the programme (Mann-Whitney U, p < 0.001). The total number of inpatient hospital days decreased from 114 (mean 4.38 +- 7.01 per patient) before beginning the programme to 3 (mean 0.12 +- 0.43 per patient) after the programme (Mann-Whitney U, p < 0.001). Estimated average emergency room charges were reduced from $US2656 to $US32, and average hospital charges were reduced from $US4380 to $US120 for equivalent pre- and post-programme periods. The requirement for prednisone pulses was reduced (t-test, p < 0.008). The mean symptom score (higher score means better function) before entrance into the programme was 0.62 +- 1.20 and improved to a mean of 3.38 +- 1.92 after participation in the programme (Mann-Whitney U, p < 0.0001). The mean activity tolerance score was 2.50 +- 2.20 before entrance into the programme and improved to a mean of 5.35 +- 1.20 after the programme (Mann-Whitney U, p < 0.0001).