Electronic monitoring of symptoms and lung function to assess asthma control in children

Vliet, Dillys van; Horck, Marieke van; Kant, Kim van de; Vaassen, Sanne; Gulikers, Sjoerd; Winkens, Björn; Rosias, Philippe; Heynens, Jan; Muris, Jean; Essers, Brigitte; Dompeling, Edward

doi:10.1016/j.anai.2014.05.015

Cited by 20 publications

(24 citation statements)

References 22 publications

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“…We can question whether the way of monitoring and the type of parameters in children with asthma is optimal in paediatric care. In a previous study, we demonstrated that prospective monitoring of symptoms and lung function by a home monitor lead to better detection of less controlled asthma than retrospective assessment of asthma control . Moreover, prospective monitoring of biomarkers of airway inflammation, for example exhaled volatile organic compounds, might provide valuable information during the monitoring of asthma in children , which in turn could increase the level of asthma control.…”

Section: Discussionmentioning

confidence: 99%

Introduction of a new paediatric asthma guideline: Effects on asthma control levels

Hammer

Sonneveld

Kant

et al. 2017

Pediatric Allergy Immunology

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Section: Discussionmentioning

confidence: 99%

Introduction of a new paediatric asthma guideline: Effects on asthma control levels

Hammer

Sonneveld

Kant

et al. 2017

Pediatric Allergy Immunology

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“…In asthma, home monitoring is more extensively studied, although only a few studies investigated the effects of home monitoring of the combination of lung function and respiratory symptoms 18 . In a recent study of our research group in 96 children with asthma, more cases of less well-controlled asthma were detected by prospective home monitoring of FEV 1 and symptoms than by a validated questionnaire during hospital visits 5 . This demonstrates the potential of home monitoring in chronic respiratory diseases in children.…”

Section: Discussionmentioning

confidence: 99%

“…A small study in adults with CF assessed whether early detection of PEx by home monitoring was possible 4 . In children with asthma, we recently demonstrated that home monitoring is better able to detect cases with less well-controlled disease than a validated questionnaire during hospital visits 5 . The aim of the present study was to test the hypothesis that electronic home monitoring of respiratory symptoms and lung function is a valuable tool to detect PEx in children with CF at an early stage.…”

mentioning

confidence: 99%

Early detection of pulmonary exacerbations in children with cystic fibrosis by electronic home monitoring of symptoms and lung function

Dompeling

Horck

Winkens³

et al. 2016

7.3 Cystic Fibrosis

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Pulmonary exacerbations (PEx) in Cystic Fibrosis (CF) are associated with an increased morbidity and even mortality. We investigated whether early detection of PEx in children with CF is possible by electronic home monitoring of symptoms and lung function. During this one-year prospective multicentre study, 49 children with CF were asked to use a home monitor three times a week. Measurements consisted of a respiratory symptom questionnaire and assessment of Forced Expiratory Volume in one second (FEV1). Linear mixed-effects and multiple logistic regression analyses were used. In the 2 weeks before a PEx, the Respiratory Symptom Score (RSS) of the home monitor increased (p = 0.051). The FEV1 as percentage of predicted (FEV1%pred) did not deteriorate in the 4 weeks before a PEx. Nevertheless, the FEV1%pred at the start of exacerbation was significantly lower than the FEV1%pred in the non-exacerbation group (mean difference 16.3%, p = 0.012). The combination of FEV1%pred and RSS had a sensitivity to predict an exacerbation of 92.9% (CI 75.0-98.8%) and a specificity of 88.9% (CI 50.7-99.4%). The combination of home monitor FEV1%pred and RSS can be helpful to predict a PEx in children with CF at an early stage.Pulmonary exacerbations in Cystic Fibrosis (CF) are important events, associated with an accelerated decline in lung function and an increased morbidity and even mortality 1 . Prevention of pulmonary exacerbations (PEx) is one of the main goals in the management of CF 2 . Currently, treatment of a PEx starts when a patient presents with an increase in (respiratory) complaints, a deterioration in lung function and/or weight loss. It often takes some time before a patient with more complaints seeks medical care. This patient delay may introduce a subsequent delay in starting antibiotic treatment, potentially resulting in a more severe course of the PEx, and a higher risk of permanent lung function loss.There are some known risk factors for PEx in children, including frequency of previous PEx, a lower baseline Forced Expiratory Volume in one second (FEV 1 ), and female sex 3 . However, in individual cases these factors do not help to decide when to start therapy timely. As PEx cannot be predicted reliably yet, there is a need for a method to detect PEx at an earlier stage. Electronic home monitoring may be useful to detect changes in lung function and respiratory complaints at an early stage. It provides the opportunity to assess symptoms and lung function on a daily or weekly basis. Data can be sent to the CF centre where they can be evaluated. In this way, disease deterioration and the occurrence of PEx may be detected earlier.

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“…One study demonstrated that a home monitoring device could detect more cases of less well-controlled asthma than retrospective assessment of control by using the ACQ; however, optimization of adherence for reliable application of this device is important. 82 Recognizing these challenges, Okelo et al 83 developed and evaluated the Pediatric Asthma Control and Communication Instrument and consider it a simple clinical tool to assess multiple dimensions of parent-reported asthma morbidity in addition to risk and control. They included an assessment of the direction of change in asthma control, the burden of disease, and the risk for poor outcomes.…”

Section: Assessment Measuresmentioning

confidence: 99%

Advances in pediatric asthma in 2014: Moving toward a population health perspective

Szefler¹

2015

Journal of Allergy and Clinical Immunology

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Electronic monitoring of symptoms and lung function to assess asthma control in children

Cited by 20 publications

References 22 publications

Introduction of a new paediatric asthma guideline: Effects on asthma control levels

Introduction of a new paediatric asthma guideline: Effects on asthma control levels

Early detection of pulmonary exacerbations in children with cystic fibrosis by electronic home monitoring of symptoms and lung function

Advances in pediatric asthma in 2014: Moving toward a population health perspective

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