Background-Electronic diary cards have advantages over paper diaries for daily collection of data on lung function and symptoms in patients with respiratory disorders. The suitability of a pen-based electronic diary (Apple Messagepad) for this purpose was assessed in a clinical trial setting. Methods-Two studies were carried out in patients with chronic obstructive airways disease: I. An open randomized two-period crossover study comparing electronic and paper diaries in 22 clinic outpatients aged 18-70. Data were collected for four weeks on each type of diary, and 2. An open study in 37 patients in general practice aged 13-80. Data were collected for four weeks on electronic diaries only.Results-In Study I , 59% of patients preferred the electronic diary and 18% preferred paper: Both paper and electronic diaries were found to be easy to use. There were fewer problematic data from the electronic diaries (0.24% of data points) compared with paper (5.6%), resulting in improved data reliability. There were more missing data, howevec with electronic diaries (8.9% vs 0.2%; p = 0.0001) which probably relates to the fact that the electronic diary did not permit retrospective entry. Data handling procedures were greatly simplified for the electronic diaries. Problems occurred with battery life and power management. Study 2 confirmed the acceptability of electronic diaries in this Downloaded from 760 B. Tiplady et. a1 patient group, and showed no battery problems using a later model of the hardware (MP 110).Conclusions-Pen-based electronic diaries are acceptable to patients, and offer m j o r benefits in terms of data reliability and simplification of data handling.
At the end of the 6 month treatment period, there were no significant differences detected between the DM and the SM groups either from the clinic or diary card data. Both groups demonstrated a significant reduction in the number of sleep-disturbed nights, by 75% in the DM group and 77% in the SM group, at the end of the study.In conclusion, for patients with mild-to-moderate asthma, either a doctor-adjusted dose regimen or a peak flow based self-management plan involving budesonide is equally efficacious. For some patients, a simple regimen, adjusted by the physician at clinic visits, may be easier to follow.
The results of this study indicate that the therapeutic use of azelastine eye drops in patients with seasonal allergic conjunctivitis or rhino-conjunctivitis can be recommended.
The aim of this study was to evaluate the occurrence of dry cough during treatment with candesartan cilexetil, enalapril, or placebo in patients with hypertension and a history of angiotensin converting enzyme (ACE)-inhibitor-related cough. Patients with confirmed cough during an enalapril (10 mg) challenge period, followed by no cough during a placebo dechallenge period were randomized to 8 weeks of double-blind treatment with candesartan cilexetil (8 mg) (n = 62), enalapril (10 mg) (n = 66), or placebo (n = 26). Incidence and severity of dry cough was evaluated by the symptom assessment questionnaire, frequency of dry cough by a visual analog scale, and the possible impact on quality of life by the minor symptom evaluation (MSE) profile. The percentage of patients with cough was significantly lower with candesartan cilexetil (35.5%) than with enalapril (68.2%, P < .001), and did not differ between candesartan cilexetil and placebo (26.9%, P > .20). Patients coughed less frequently and with less severe cough with candesartan cilexetil than with enalapril, and similarly with candesartan cilexetil and placebo. Changes in the MSE profile were minor, although candesartan cilexetil had better scores for contentment than placebo (P = .03), and also tended to be associated with better sleep than enalapril (P = .08). In hypertensive patients with ACE-inhibitor-induced cough, the incidence, frequency, and severity of dry cough was significantly lower with candesartan cilexetil than with enalapril, and no different from that found with placebo.
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