Type

Journal Article

Authors

Richard W Costello
Richard B Reilly
Martin Holmes
Terrence Taylor
Aoife Breathnach
Elaine Mac Hale
Imran Sulaiman
Isabelle Killane

Subjects

Medicine & Nursing

Topics
multisite longitudinal randomised control trial regression analysis patient monitoring biomedical engineering and bioengineering engineering decision support system age decision support systems respiratory medicine body mass index asthma exacerbations inhaler medication dose counter adherence diseases poisson distribution pneumodynamics gender univariate modified poisson regression multivariate modified poisson regression remote monitoring adherence device

Predicting asthma exacerbations employing remotely monitored adherence (2016)

Abstract This Letter investigated the efficacy of a decision-support system, designed for respiratory medicine, at predicting asthma exacerbations in a multi-site longitudinal randomised control trial. Adherence to inhaler medication was acquired over 3 months from patients with asthma employing a dose counter and a remote monitoring adherence device which recorded participant's inhaler use: n = 184 (23,656 audio files), 61% women, age (mean ± sd) 49.3 ± 16.4. Data on occurrence of exacerbations was collected at three clinical visits, 1 month apart. The relative risk of an asthma exacerbation for those with good and poor adherence was examined employing a univariate and multivariate modified Poisson regression approach; adjusting for age, gender and body mass index. For all months dose counter adherence was significantly (p < 0.01) higher than remote monitoring adherence. Overall, those with poor adherence had a 1.38 ± 0.34 and 1.42 ± 0.39 (remotely monitored) and 1.25 ± 0.32 and 1.18 ± 0.31 (dose counter) higher relative risk of an exacerbation in model 1 and model 2, respectively. However, this was not found to be statistically significantly different. Remotely monitored adherence holds important clinical information and future research should focus on refining adherence and exacerbation measures. Decision-support systems based on remote monitoring may enhance patient-physician communication, possibly reducing preventable adverse events.
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Full list of authors on original publication

Richard W Costello, Richard B Reilly, Martin Holmes, Terrence Taylor, Aoife Breathnach, Elaine Mac Hale, Imran Sulaiman, Isabelle Killane

Experts in our system

1
Richard W Costello
Royal College of Surgeons in Ireland
Total Publications: 69
 
2
Richard Reilly
Trinity College Dublin
Total Publications: 195
 
3
Martin Holmes
Royal College of Surgeons in Ireland
Total Publications: 15
 
4
Aoife Breathnach
Royal College of Surgeons in Ireland
 
5
Elaine Mac Hale
Royal College of Surgeons in Ireland
Total Publications: 3
 
6
Imran Sulaiman
Royal College of Surgeons in Ireland
Total Publications: 26
 
7
Isabelle Killane
Royal College of Surgeons in Ireland
Total Publications: 14