An interactive monitoring device reduced asthma symptoms and functional limitations in inner city children with asthma.

QUESTION: Does an interactive, home based device that monitors asthma symptoms, aspects of quality of life, and self care (Health Buddy) reduce asthma symptoms and increase self care behaviours in inner city children with persistent asthma?DesignRandomised {allocation concealed}*, controlled trial with follow up at 6 and 12 weeks.SettingAn inner city primary care clinic in Oakland, California, USA.Patients134 children who were 8-16 years of age (mean age 12y, 57% boys, 76% African-American), had a diagnosis of persistent asthma, had an English speaking caregiver, and had a telephone at home. Exclusion criteria were involvement. in other asthma or drug efficacy studies or behaviour modification research, mental or physical challenges that made it difficult to use the Health Buddy, or comorbid conditions affecting quality of life. Follow up was 96% at 6 weeks and 91% at 12 weeks.Intervention66 children were allocated to the Health Buddy (Health Hero Network, Mountain View, California), an interactive device connected to a home telephone. Each day, nurse coordinator sent a set of queries (dialogues) using a standard internet browser. Children answered the queries by pressing 1 of 4 buttons. The dialogues were aimed at a third grade reading level and consisted of 10 questions about asthma symptoms, peak flow readings, use of medication and health services, and functional status. Each answer by the child received immediate feedback from the device fie, praise for a correct answer or encouragement to try again). Children were to access the device on their own at a regular time once each day. 68 children were allocated to the control group and used a standard asthma diary to log their symptoms. peak flow, medication use, and restricted activity.Main outcome measuresMain outcome was limitation in activity because of asthma Secondary outcomes included peak flow readings in the red zone (< 50% of personal best, signalling severe asthma exacerbation) or yellow zone (50% to 80% of personal best, signalling asthma that is not sufficiently controlled and requires additional medication), and perceived asthma symptoms in the previous 14 days; missed school days and use of health services because of astlma in the previous 6 weeks; and self care behaviours.Main resultsAnalyses adjusted for different visits, asthma severity, and baseline symptoms showed that children allocated to the Health Buddy were less likely than children allocated to the asthma diary to report limitations in activities (odds ratio [OR] 0.52, 95% CI 0.29 to 0.94), made fewer urgent calls to health services (OR 0.43, CI 0.18 to 0.99), and were more likely to take their asthma medication without additional reminders (p=0.04). They were also less likely to have peak flow readings in the yellow or red zones (OR 0.43, C1 0.23 to 0.82). The groups did not differ for coughing or wheezing (p=0.23), trouble sleeping (p=0.83), emergency department visits (p=0.21), or hospital admissions (p=0.96).ConclusionIn inner city children with asthma, an interactive communication device for monitoring asthma symptoms and functional status reduced limitations in activity and urgent calls to health services when compared with a standard asthma diary.* Information provided by author. [ABSTRACT FROM AUTHOR]