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Meta-Analysis
. 2010 Oct 6;2010(10):CD007717.
doi: 10.1002/14651858.CD007717.pub2.

Telehealthcare for asthma

Susannah McLean  1 , David Chandler, Ulugbek Nurmatov, Joseph Liu, Claudia Pagliari, Josip Car, Aziz Sheikh
Affiliations
Meta-Analysis

Telehealthcare for asthma

Susannah McLean et al. Cochrane Database Syst Rev. .

Abstract

Background: Healthcare systems internationally need to consider new models of care to cater for the increasing numbers of people with asthma. Telehealthcare interventions are increasingly being seen by policymakers as a potential means of delivering asthma care. We defined telehealthcare as being healthcare delivered from a distance, facilitated electronically and involving the exchange of information through the personalised interaction between a healthcare professional using their skills and judgement and the patient providing information.

Objectives: To assess the effectiveness of telehealthcare interventions in people with asthma.

Search strategy: We searched in the following databases: Cochrane Central Register of Controlled Trials (CENTRAL), MEDLINE, EMBASE, CINAHL, AMED, and PsycINFO; this was supplemented by handsearching of respiratory journals. We also searched registers of ongoing and unpublished trials.

Selection criteria: We selected completed randomised controlled trials of telehealthcare initiatives aiming to improve asthma care.

Data collection and analysis: Two review authors independently appraised studies for inclusion and extracted data and performed meta-analyses. We analysed dichotomous variables to produce an odds ratio (OR) and continuous variables to produce a mean difference.

Main results: We included 21 trials in this review. The 21 included studies investigated a range of technologies aiming to support the provision of care from a distance. These included: telephone (n = 9); video-conferencing (n = 2); Internet (n = 2); other networked communications (n = 6); text Short Messaging Service (n = 1); or a combination of text and Internet (n = 1). Meta-analysis showed that these interventions did not result in clinically important improvements in asthma quality of life (minimum clinically important difference = 0.5): mean difference in Juniper's Asthma Quality of Life Questionnaire (AQLQ) 0.08 (95% CI 0.01 to 0.16). Telehealthcare for asthma resulted in a non-significant increase in the odds of emergency department visits over a 12-month period: OR 1.16 (95% CI 0.52 to 2.58). There was, however, a significant reduction in hospitalisations over a 12-month period: OR 0.21 (95% CI 0.07 to 0.61), the effect being most marked in people with more severe asthma managed predominantly in secondary care settings.

Authors' conclusions: Telehealthcare interventions are unlikely to result in clinically relevant improvements in health outcomes in those with relatively mild asthma, but they may have a role in those with more severe disease who are at high risk of hospital admission. Further trials evaluating the effectiveness and cost-effectiveness of a range of telehealthcare interventions are needed.

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Conflict of interest statement

All of the authors are working on other projects in telehealth and e‐health funded by the NHS Connecting for Health Evaluation Programme 001 Extension and JL is in addition working on a Medicaid funded project. SM is funded by the Chief Scientist's Office. AS worked with Pinnock et al and is a co‐author on the 2003, 2005 and 2007 papers included in this review.

This report is independent research supported by the National Institute of Health Research. The views expressed in this publication are those of the author(s) and not necessarily those of the NHS, the National Institute of Health Research or the Department of Health.

Figures

1
1
PRISMA flow diagram
2
2
3
3
Forest plot of comparison: 1 Asthma quality of life questionnaires, outcome: 1.1 AQLQ Juniper mean scores.
4
4
Funnel plot of comparison: 1 Asthma quality of life questionnaires, outcome: 1.1 AQLQ Juniper mean scores.
5
5
Forest plot of comparison: 2 One or more emergency dept visit in 12 months, outcome: 2.2 Emergency department in 12 months.
6
6
Funnel plot of comparison: 2 One or more emergency dept visit in 12 months, outcome: 2.2 Emergency department in 12 months.
7
7
Forest plot of comparison: 1 Hospitalisation, outcome: 1.2 Proportion hospitalised in 3 months of study.
8
8
Funnel plot of comparison: 2 Proportion hospitalised in 12 months of study, outcome: 2.1 Proportion hospitalised in 3 months of study.
9
9
Forest plot of comparison: 3 Proportion hospitalised in 12 months of study, outcome: 3.2 Proportion hospitalised in 12 months of study.
10
10
Funnel plot of comparison: 3 Proportion hospitalised in 12 months of study, outcome: 3.2 Proportion hospitalised in 12 months of study.
11
11
1.1
1.1. Analysis
Comparison 1 Asthma quality of life questionnaires, Outcome 1 AQLQ Juniper mean scores.
1.2
1.2. Analysis
Comparison 1 Asthma quality of life questionnaires, Outcome 2 Sensitivity analysis AQLQ studies judged low risk of bias.
1.3
1.3. Analysis
Comparison 1 Asthma quality of life questionnaires, Outcome 3 Subgroup telephone only AQLQ scores.
1.4
1.4. Analysis
Comparison 1 Asthma quality of life questionnaires, Outcome 4 Subgroup AQLQ recruited in secondary care.
1.5
1.5. Analysis
Comparison 1 Asthma quality of life questionnaires, Outcome 5 Subgroup AQLQ recruited in primary care.
2.1
2.1. Analysis
Comparison 2 One or more emergency department visit; no. of patients with events, Outcome 1 Emergency department visit in 3 months.
2.2
2.2. Analysis
Comparison 2 One or more emergency department visit; no. of patients with events, Outcome 2 Emergency department visit in 12 months.
2.3
2.3. Analysis
Comparison 2 One or more emergency department visit; no. of patients with events, Outcome 3 Subgroup secondary care populations.
2.4
2.4. Analysis
Comparison 2 One or more emergency department visit; no. of patients with events, Outcome 4 Subgroup primary care populations.
3.1
3.1. Analysis
Comparison 3 One or more hospitalisation events; no. of patients with events, Outcome 1 One or more hospitalisation event in 3 months of study.
3.2
3.2. Analysis
Comparison 3 One or more hospitalisation events; no. of patients with events, Outcome 2 One or more hospitalisation event in 12 months of study.
3.3
3.3. Analysis
Comparison 3 One or more hospitalisation events; no. of patients with events, Outcome 3 Subgroup ‐ secondary care; no. of patients with one or more hospitalisations in 12 months.
3.4
3.4. Analysis
Comparison 3 One or more hospitalisation events; no. of patients with events, Outcome 4 Subgroup ‐ primary care; no. of patients with one or more hospitalisations in 12 months.
3.5
3.5. Analysis
Comparison 3 One or more hospitalisation events; no. of patients with events, Outcome 5 No. of patients with one or more hospitalisation events in 12 months excluding Kokubu study.
See this image and copyright information in PMC

Comment in

  • Telemedizin: Besser leben mit Asthma?
    Krome S. Krome S. Dtsch Med Wochenschr. 2011 Mar;136(12):570. doi: 10.1055/s-0031-1275639. Dtsch Med Wochenschr. 2011. PMID: 21528506 German. No abstract available.

References

References to studies included in this review

Barbanel 2003 {published data only}
    1. Barbanel D, Eldridge S, Griffiths C. Can a self‐management programme delivered by a community pharmacist improve asthma control? A randomised trial. Thorax 2003;58:851‐4. - PMC - PubMed
Bynum 2001 {published data only}
    1. Bynum A, Hopkins D, Thoma A, Copeland N, Irwin C. The effect of telepharmacy counselling on metered‐dose inhaler technique among adolescents with asthma in rural Arkansas. Telemedicine Journal and eHealth 2001;7(3):207‐16. - PubMed
Chan 2007 {published data only}
    1. Chan D, Callahan C, Hatch‐Pigott V, Lawless A, Proffitt L, Manning N, Schweikert M, Malone F. Internet based home monitoring and education of children with asthma is comparable to ideal office‐based care: results of a 1‐year asthma in‐home monitoring trial. Pediatrics 2007;119:569‐78. - PubMed
Chatkin 2006 {published data only}
    1. ChatkinJ, Blanco D, Scaglia N, Wagner M, Fritscher C. Impact of a low cost and simple intervention in enhancing treatment adherence in a Brazilian asthma sample. Journal of Asthma 2006;43:263‐6. - PubMed
Clark 2007 {published data only}
    1. Clark N, Gong M, Wang S, Lin X, Bria W, Johnson T. A randomized trial of a self‐regulation intervention for women with asthma. Chest 2007;132:88‐97. - PubMed
Cruz‐Correia 2007 {published data only}
    1. Cruz‐Correia R, Fonseca J, Lima L, Araujo L, Delgado L, et al. Web‐based or paper‐based self‐management tools for asthma‐patients opinions and quality of data in a randomized crossover study. Studies in Health Technology and Informatics 2007;127:178‐89. - PubMed
de Jongste 2009 {published data only}
    1. Jongste JC, Carraro S, Hop WC, The CHARISM Study Group and Baraldi E. Daily telemonitoring of exhaled nitric oxide and symptoms in the treatment of childhood asthma. American Journal of Respiratory and Critical Care Medicine 2009;179:93‐7. - PubMed
Donald 2008a {published data only}
    1. Donald K, McBurney H, Teichtahl H, Irving L. A pilot study of telephone based asthma management. Australian Family Physician 2008;37(3):170‐3. - PubMed
Donald 2008b {published data only}
    1. Donald K, McBurney H, Teichtahl H, Irving L, Browning C, Rubinfeld A, et al. Telephone based asthma management; financial and individual benefits. Australian Family Physician 2008;37(4):212‐75. - PubMed
Gruffydd‐Jones 2005 {published data only}
    1. Gruffydd‐Jones K, Hollinghurst S, Ward S, Taylor G. Targeted routine asthma care in general practice using telephone triage. British Journal of General Practice 2005;55:918‐23. - PMC - PubMed
Guendelman 2002 {published data only}
    1. Guendelman S, Meade K, Benson M, Chen YQ, Samuels S. Improving asthma outcomes and self management behaviors of inner city children. Archives of Pediatric Adolescent Medicine ry 2002;156:114‐20. - PubMed
Jan 2007 {published data only}
    1. Jan RL, Wang J, Huang M, Tseng SM, Su HJ, Liu LF. An internet based interactive telemonitoring system for improving childhood asthma outcomes in Taiwan. Telemedicine and eHealth 2007;13(3):257‐68. - PubMed
Khan 2004 {published data only}
    1. Khan M, O'Meara M, Stevermuer T, Henry R. Randomised controlled trial of asthma education after discharge from an emergency department. Journal of Paediatrics and Child Health 2004;40:674‐7. - PubMed
Kokubu 1999 {published data only}
    1. Kokubu F, Suzuki H, Sano Y, Kihara N, Adachi M. Tele‐medicine system for high‐risk asthmatic patients. Arerugi 1999;48(7):700‐12. - PubMed
Kokubu 2000 {published data only}
    1. Kokubu F, Nakajima S, Ito K, Makino S, Kitamura S, Fukuchi Y, et al. Hospitalization reduction by an asthma telemedicine system. Arerugi 2000;49(1):19‐31. - PubMed
Ostojic 2005 {published data only}
    1. Ostojic V, Cvoriscec B, Ostojc S, Reznikoff D, Stipic‐Markovic A, Tudjman Z. Improving asthma control through telemedicine a study of Short‐Message Service. Telemedicine and eHealth 2005;11(1):28‐35. - PubMed
Pinnock 2003 {published data only}
    1. Pinnock H, Bawden R, Proctor S, Wolfe S, Scullion J, Price D, et al. Accessibility, acceptability, and effectiveness in primary care of routine telephone review of asthma: pragmatic randomised controlled trial. BMJ 2003;326:477‐9. - PMC - PubMed
Pinnock 2005 {published data only}
    1. Pinnock H, McKenzie L, Price D, Sheikh A. Cost‐effectiveness of telephone or surgery asthma reviews: economic analysis of a randomised controlled trial. British Journal of General Practice 2005;55:119‐24. - PMC - PubMed
Pinnock 2007 {published data only}
    1. Pinnock H, Adlem L, Gaskin S, Harris J, Snellgrove C, Sheikh A. Accessibility, clinical effectiveness and practice costs of providing a telephone option for routine asthma reviews: phase IV controlled implementation study. British Journal of General Practice 2007;57:714‐22. - PMC - PubMed
Rasmussen 2005 {published data only}
    1. Rasmussen L, Phanareth K, Nolte H, Backer V. Internet‐based monitoring of asthma: a long term randomized clinical study of 300 asthmatic subjects. Journal of Allergy and Clinical Immunology 2005;115(6):1137‐42. - PubMed
Van der Meer 2009 {published data only}
    1. Meer V, Bakker MJ, Hour W, Rabe KF, Sterk PJ, Kievit J, Assendelft WJ, Sont JK. Internet‐based self management plus education compared with usual care in asthma. Annals of Internal Medicine 2009;151:110‐20. - PubMed
Vollmer 2006 {published data only}
    1. Vollmer W, Krishner M, Peters D, Drane A, Stibolt T, Hickey T, et al. Use and impact of an automated telephone outreach system for asthma in a managed care setting. American Journal of Managed Care 2006;12(12):725‐33. - PubMed
Willems 2007a {published data only}
    1. Willems D, Joore M, Hendriks J, Wouters E, Severens J. Cost effectiveness of a nurse‐led telemonitoring intervention based on peak expiratory flow measurements in asthmatics: results of a randomised controlled trial. Cost Effectiveness and Resource Allocation 2007;5:10. - PMC - PubMed
Willems 2007b {published data only}
    1. Willems D, Joore M, Hendriks J, Duurling R, Wouters E, Severens J. Process evaluation of a nurse‐led telemonitoring programmer for patients with asthma. Journal of Telemedicine and Telecare 2007;13:310‐17. - PubMed
Willems 2008 {published data only}
    1. Willems DC, Joore MA, Hendriks JJE, Nieman FHM, Severens JL, Wouteres EFM. The effectiveness of nurse‐led telemonitoring of asthma results of a randomized controlled trial. Journal of Evaluation in Clinical Practice 2008;14:600‐9. - PubMed

References to studies excluded from this review

Bergman 2008 {published data only}
    1. Bergman D, Sharek PJ, Kekgran K, et al. The use of telemedicine access to schools to facilitate expert assessment of children with asthma. International Journal of Telemedicine Applications 2008;159:276. - PMC - PubMed
Boone 2002 {published data only}
    1. Boone D, Counsell P, et al. Effect of computer‐assisted education on inhaler technique and knowledge in children with asthma. European Respiratory Society Annual Congress 2002:P2062.
Burkhart 1996 {published data only}
    1. Burkhart P. Effect of contingency management on adherence to peak flow monitoring in school age children with asthma. University of Pittsburgh 1996 PHD, p 276.
Burkhart 2007 {published data only}
    1. Burkhart PV. Testing an Intervention to Promote Children's Adherence to Asthma Self‐Management. Journal of Norsing Scholarship 2007;39(2):133‐140. - PubMed
Chan 2003 {published data only}
    1. Chan D, Callahan C, Sheets S, Moreno C, Malone F. An Internet‐based store and forward video home telehealth system for improving asthma outcomes in children. American Journal of Health‐System Pharmacy 2003;60:1976‐81. - PubMed
Chandler 1990 {published data only}
    1. Chandler M, Clifton D, Louis B, Coons S, Foster T, Phillips B. Home monitoring of theophylline levels: a novel therapeutic approach. Pharmacotherapy 1990;10(4):294‐300. - PubMed
Delaronde 2005 {published data only}
    1. Delaronde S, Peruccio D, Bauer B. Improving asthma treatment in a managed care population. American Journal of Managed Care 2005;11(6):361‐8. - PubMed
Finkelstein 1998 {published data only}
    1. Finkelstein J, Hripcsak G, Cabrera M. Telematic system for monitoring of asthma severity in patients' homes. Studies in Health Technology and Informatics 1998;52 (Pt 1):272‐6. - PubMed
Finkelstein 2000 {published data only}
    1. Finkelstein J, Cabrera M, Hripcsak G. Internet‐based home asthma telemonitoring: can patients handle the technology?. Chest 2000;179(2):148‐55. - PubMed
Finkelstein 2001 {published data only}
    1. Finkelstein J, O'Connor G, Friedmann RH. Development and implementation of the home asthma telemonitoring HAT system to facilitate asthma self‐care. Medinfo 2001;10(1):810‐14. - PubMed
Finkelstein 2007 {published data only}
    1. Finkelstein J, Gangopadhyay A. Using machine learning to predict asthma exacerbations. AMIA Annual Symposium Proceedings/AMIA Symposium 2007;11:955. - PubMed
Huss 1992 {published data only}
    1. Huss K. Computer education for asthmatics: what effects?. Journal of Nursing Care Quality 1992;6(3):57‐66. - PubMed
Huss 2003 {published data only}
    1. Huss K. Computer game for inner city children does not improve asthma outcomes. Journal of Pediatric Health Care 2003;17(2):72‐8. - PubMed
Jaana 2009 {published data only}
    1. Janna M, Pare G, Sicotte C. Home telemonitoring for respiratory conditions: a systematic review. American Journal of Managed Care 2009;14(5):313‐20. - PubMed
Joseph 2007 {published data only}
    1. Joseph CL, Peterson E, Havstad S, Johnson CC, Hoerauf S, Stringer S, et al. A web‐based tailored asthma management program for urban African‐American high school students. American Journal of Respiratory and Critical Care Medicine 2007;175(9):888‐95. - PMC - PubMed
Joshi 2009 {published data only}
    1. Joshi A, Weng W, Lichenstein R, Arora M, Sears A. Prospective tracking of a pediatric emergency department e‐kiosk to deliver asthma education. Health Informatics Journal 2009;15(4):282‐95. - PubMed
Karp 2000 {published data only}
    1. Karp W, Grigsby R, McSwiggan‐Hardin M, Pursley‐Crotteau S, Adams LN, Bell W, et al. Use of telemedicine for children with special healthcare needs. Paediatrics 2000;105:843‐7. - PubMed
Le 2007 {published data only}
    1. TT Holbrook JT, et al. Effectiveness and acceptability of computer‐based asthma education. American Thoracic Society International Conference May 18‐23:A93.
Lin 2009 {published data only}
    1. Lin SP, Yang HY. Exploring key factors in the choice of e‐health using an asthma care mobile service model. Telemedicine and eHealth 2009;15(9):884‐9. - PubMed
Maiolo 2003 {published data only}
    1. Maiolo C, Moamed El, Fiorani CM, Lorenzo A. Home telemonitoring for patients with severe respiratory illness: the Italian experience. Journal of Telemedicine and Telecare 2003;22:1372‐8. - PubMed
Malone 2004 {published data only}
    1. Malone F, Calahan C, Chan DS, Sheets, MS Person DA. Caring for children with asthma through teleconsultation: "ECHO‐Pac, the electronic children's hospital of the Pacific". Telemedicine Journal and eHealth 2004;10(2):138‐46. - PubMed
Marcin 2004 {published data only}
    1. Marcin J, Ellis J, Mawis R, Nagrampa E, Nesbitt TS, Dimand RJ. Using telemedicine to provide pediatric subspeciality care to children with special healthcare needs in an underserved rural community. Pediatrics 2004;113:1‐6. - PubMed
McCLure 2008 {published data only}
    1. McClure LA, Harrington K, Graham H, Gerald LB. Internet‐based monitoring of asthma symptoms peak flow meter reading and absence data in a school based clinical trial. Clinical Trials 2008;5:31‐7. - PMC - PubMed
Patel 2009 {published data only}
    1. Patel R, Saltoun C, Grammer L. Improving asthma care for the elderly: as randomised controlled trial using a simple telephone intervention. Journal of Asthma 2009;46:30‐5. - PubMed
Pinnock 2007b {published data only}
    1. Pinnock H, Slack R, Pagliari C, Price D, Sheikh A. Understanding the potential role of mobile phone‐based monitoring on asthma self‐management: qualitative study. Clinical Experimental Allergy 2007;37(5):794‐802. - PubMed
Porter 2006 {published data only}
    1. Porter SC, Forbes P, Feldman HA, Goldmann DA. Impact of patient‐centered decision support on quality of asthma care in the emergency department. Pediatrics 2006;117(1):e33‐42. - PubMed
Reddel 1998 {published data only}
    1. Reddel H, Ware S, Salome C, Henkins C, Woolcock A. Pitfalls in processing home electronic spirometric data in asthma. European Respiratory Journal 1998;12:853‐8. - PubMed
Smith 2009 {published data only}
    1. Smith SM, Elkin SL, Partridge MR. Technology and its role in respiratory care. Primary Care Respiratory Journal 2009;18(3):159‐64. - PMC - PubMed
Sockrider 2006 {published data only}
    1. Sockrider M, Abramson S, Brooks E, Caviness C, Pilney S, Koerner C, et al. Delivering tailored asthma family education in a pediatric emergency department setting: a pilot study. Pediatrics 2006;117:S135‐S144. - PubMed
van den Berg 2002 {published data only}
    1. Berg NJ, Have WH. Is the availability of a 24 hour asthma‐telephone useful in the implementation of asthma treatment guidelines for children aged 6‐16 years among general practitioners?. Conference Abstract European Respiratory Society Annual Congress 2002:P2051.
Wise 2007 {published data only}
    1. Wise M, Gustafson DH. Internet telehealth for pediatric asthma management: integrating computerised and case manager features for tailoring a web‐based asthma education program. Health Promotion Practice 2007;8(3):282‐91. - PMC - PubMed
Young 2003 {published data only}
    1. Young TL, Ireson C. Effectiveness of school‐based telehealthcare in urban and rural elementary schools. Pediatrics 2003;112(5):1088‐94. - PubMed
Zamith 2009 {published data only}
    1. Zamith M, Cardoso T, Matias I, Marques Gomes MJ. Home telemonitoring of severe chronic respiratory insufficiency and asthmatic patients. Revista Portuguesa de Pneumologia 2009;15(3):385‐417. - PubMed

References to ongoing studies

ACTRN12606000400561 {published data only}
    1. Improving childhood asthma management through a telemedicine monitoring network. Ongoing study 11 September 2006.
Apter NCT00115323 {published data only}
    1. Comparison of two medication adherence strategies to improve asthma treatment adherence. Ongoing study May 2005.
Bendeer NCT00958932 {published data only}
    1. Telecommunication Enhanced Asthma Management TEAM. Ongoing study Sept 2009.
Clover N0702196597 {published data only}
    1. Self‐management of chronic conditions using telemedicine. Ongoing study —.
Finkelstein CRISP {published data only}
    1. Inhaled steroid adherence in moderate and severe asthma. Ongoing study 2005.
Friedman CRISP {published data only}
    1. Impact of a telecommunication system in childhood asthma. Ongoing study 1999.
Garbutt NCT00660322 {published data only}
    1. Using the telephone to improve care in childhood asthma. Ongoing study Jan 2004.
Garbutt NCT 00860834 {published data only}
    1. Parents, pediatricians and asthma telephone coaches partner to improve control of asthma in children (The PARTNER Study). Ongoing study August 2008.
Gustafson NCT00214383 {published data only}
    1. Internet Telehealth for Pediatric Asthma Case Management CHESS. Ongoing study May 2004.
Gustafson NCT00993590 {published data only}
    1. Mobile CHESS Research on Emergency Medical Services for Children. Ongoing study June 2008.
Mayers NCT00562081 {published data only}
    1. The Virtual Asthma Clinic. Ongoing study March 2005.
Moldrup NCT00917410 {published data only}
    1. Mobile phone text for optimising asthma treatment. Ongoing study November 2007.
NCT00149474 {published data only}
    1. Peak flow monitoring in older adults with asthma. Ongoing study August 1994.
Osman N0411013273 {published data only}
    1. A randomised controlled trial of benefits of specialist review or telephone follow up after an Accident and Emergency attendance for asthma. Ongoing study 1 October 1997.
Partridge N0016132017 {published data only}
    1. Proposal to study whether we can reduce hospital attendance by those with respiratory conditions without compromising care by the use of telephone consultation. Ongoing study 13 August 2003.
Perry NCT00964301 {published data only}
    1. Telemedicine education for rural children with asthma. Ongoing study August 2009.
Ricci 2001 In progress {published data only}
    1. A telehealthcare system for home monitoring of respiratory function in children affected by bronchial asthma. Ongoing study 2001.
Ryan NCT 00512837 {published data only}
    1. Mobile phone based structured intervention, the CYMPLA trial. Ongoing study November 2007.
Sparrow NCT00232557 {published data only}
    1. Telecommunications system in asthma. Ongoing study August 2004.
Strunk NCT00910585 {published data only}
    1. Coaching in childhood asthma. Ongoing study January 1997.
Vollmer NCT 00414817 {published data only}
    1. Telephone‐based program to promote inhaled corticosteroid adherence among individuals with asthma. Ongoing study June 2007.
Wouters NCT 00411346 {published data only}
    1. Patient Research In Self‐Management of Asthma (PRISMA). Ongoing study January 2003.

Additional references

Anandan 2009
    1. Anandan C, Gupta R, Simpson CR, Fischbacher C, Sheikh A. Epidemiology and disease burden from allergic disease in Scotland: analyses of national databases. Journal of the Royal Society of Medicine 2009;102(10):431‐42. - PMC - PubMed
Anandan 2010
    1. Anandan C, Nurmatov U, Sheikh A. Is the prevalence of asthma declining, systematic review of epidemiological studies. Allergy 2010;65(2):152‐67. - PubMed
Anderson 2007
    1. Anderson HR, Gupta R, Strachan DP, Limb ES. 50 years of asthma: UK trends from 1955 to 2004. Thorax 2007;62(1):85‐90. - PMC - PubMed
Botsis 2008
    1. Botsis T, Hartvigsen G. current status and future perspectives in telecare for elderly people suffering from chronic diseases. Journal of Telemedicine and Telecare 2008;14:195‐203. - PubMed
BTS/SIGN 2008
    1. British Thoracic Society, Scottish Intercollegiate Guidelines Network. British Guideline on Asthma. National Guideline 2008.
Busey 2008
    1. Busey C, Michael P. Telehealth ‐ opportunities and pitfalls. Journal of the American Dietetic Association 2008;108(8):1296‐301. - PubMed
Car 2003
    1. Car J, Sheikh A. Telephone consultations. BMJ 2003;326:966‐9. - PMC - PubMed
Car 2004a
    1. Car J, Sheikh A. Email consultations in health care: 1 ‐ scope and effectiveness. BMJ 2004;329:435‐8. - PMC - PubMed
Car 2004b
    1. Car J, Sheikh A. Email consultations in health care: 2 ‐ acceptability and safe application. BMJ 2004;329:439‐42. - PMC - PubMed
Catwell 2009a
    1. Catwell L, Sheikh A. Evaluating eHealth interventions: the need for continuous systemic evaluation. Plos Medicine 2009;6(8):e1000126. - PMC - PubMed
Catwell 2009b
    1. Catwell L, Sheikh A. Information technology (IT) system users must be allowed to decide on the future direction of major national IT initiatives. But the task of redistributing power equally amongst stakeholders will not be an easy one. Informatics in Primary Care 2009;17(1):1‐4. - PubMed
Currell 2008
    1. Currell R, Urquhart C, Wainwright P, Lewis R. Telemedicine versus face to face patient care: effects on professional practice and health care outcomes. Cochrane Database of Systematic Reviews 2000, Issue 2. [DOI: 10.1002/14651858.CD002098] - DOI - PubMed
Duvvuri 2007
    1. Duvvuri VRSK, Jianhong W. Information and communication technology developments in asthma management: a systematic review. Indian Journal of Medical Science 2007;61(4):221‐41. - PubMed
Finkelstein 2000a
    1. Finkelstein J, Friedman RH. Potential role of telecommunication technologies in the management of chronic health conditions. Disease Management Health Outcomes 2000;2:57‐63.
Gallagher 2009
    1. Gallagher M, Worth A, Sheikh A. Clinical allergy has much to gain from engagement with qualitative research. Allergy 2009;64(8):1117‐9. - PubMed
Garcia‐Lizana 2007
    1. Garcia Lizana F, Sarria‐Santamera A. New technologies for chronic disease management and control: a systematic review. Journal of Telemedicine and Telecare 2007;13:62‐8. - PubMed
GINA 2003
    1. Masoli M, Fabian D, Holt S, Beasley R. Global Burden of Asthma. The Global Initiative for Asthma 2003.
Gupta 2003
    1. Gupta R, Sheikh A, Strachan DP, Anderson HR. Burden of allergic disease in the UK: secondary analyses of national databases. Clinical and Experimental Allergy 2004;34(4):520‐6. - PubMed
Higgins 2009
    1. Higgins JPT, Green S (editors). Cochrane Handbook for Systematic Reviews of Interventions Version 5.0.2 [updated September 2009]. Available from www.cochrane‐handbook.org. The Cochrane Collaboration, 2008.
HRSA 2008
    1. USA Health Resources and Services Administration. http://www.hrsa.gov/telehealth/ (accessed 26 September 2008).
ISAAC 1998
    1. International Study of Asthma and Allergies in Childhood Steering Committee. Worldwide variations in the prevalence of asthma symptoms: ISAAC. European Respiratory Journal 1998;12:315‐35. - PubMed
ISAAC 2001
    1. Stewart AW, Mitchell EA, Pearce N, Strachan D, Weiland S, on behalf of the ISAAC Steering Committee. The relationship of per capita gross national product to the prevalence of symptoms of asthma and other atopic diseases in children (ISAAC). International Journal of Epidemiology 2001;30:173‐9. - PubMed
ISAAC 2004
    1. Weiland SK, Björkstén B, Brunekreef B, Cookson WO, Mutius E, Strachan DP. Phase II of the International Study of Asthma and Allergies in Childhood (ISAAC II): rationale and methods. European Respiratory Journal 2004;24(3):406‐12. - PubMed
ISAAC 2006
    1. Asher MI, Montefore S, Bjorksten B, Lai C, Strachan DP, Weilland SK, Williams H and the ISAAC Phase Three Study Group. Worldwide time trends in the prevalence of symptoms of asthma, allergic rhinoconjunctivitis and eczema in childhood: ISAAC Phases One and Three repeat multi country cross‐sectional surveys. Lancet 2006;368:733‐43. - PubMed
Juniper 1996
    1. Juniper EF, Guyatt GH, Feeny DH, Ferrie PJ, Griffith LE, Townsend M. Measuring quality of life in the parents of children with asthma. Quality of Life Research 1996;5:27‐34. - PubMed
Juniper 1999
    1. Juniper EF, Guyatt GH, Cox FM, Ferrie PJ, King DR. Development and validation of the Mini Asthma Quality of Life Questionnaire. European Respiratory Journal 1999;14:32‐8. - PubMed
Lancet 2006
    1. Lancet 2006. A plea to abandon asthma as a disease concept. Lancet 2006;368(9537):705. - PubMed
Lancet 2008
    1. Lancet. Asthma: still more questions that answers. Lancet 2008;372(9643):1009. - PubMed
Lorentz 2008
    1. Lorentz M. Telenursing and home healthcare. Home Healthcare Nurse 2008;4:26. - PubMed
Mahen 2006
    1. Mahen MM, Allen A. E‐Health & Telehealth Glossary. http://telehealth.net/glossary.html 2006 (accessed 26 September 2008).
Mair 2000
    1. Mair F, Whitten P. Systematic review of studies of patient satisfaction with telemedicine. BMJ 2000;320:1517‐20. - PMC - PubMed
Marks 2001
    1. Marks G. Commentary: geographical heterogeneity of asthma. International Journal of Epidemiology 2001;30:179‐80. - PubMed
McKinstry 2009
    1. McKinstry B, Pinnock H, Sheikh A. Telemedicine for management of patients with COPD?. Lancet Aug 2009;374(9691):672‐3. - PubMed
McLean 2009a
    1. McLean S, Sheikh A. Does telehealthcare offer a patient‐centred way forward for the community‐based management of long‐term respiratory disease?. Primary Care Respiratory Journal 2009;18(3):159‐64. - PMC - PubMed
McLean 2009b
    1. McLean S, Nurmatov U, Liu J, Pagliari C, Car J, Sheikh A. Telehealthcare for COPD. Cochrane Database of Systematic Reviews Unpublished. - PMC - PubMed
Medical Research Council 2008
    1. Craig P, Dieppe P, MacIntyre S, Michie S, Nazareth I, Petticrew M. Developing and evaluating complex interventions: new guidance. Medical Research Council 2008.
Miller 2007
    1. Miller E. Solving the disjuncture between research and practice; telehealth trends in the 21st Century. Health Policy 2007;82:133‐41. - PubMed
Mort 2008
    1. Mort M, Finch T, May C. Making and unmaking telepatients: identity and governance in new health technologies. Science, Technology and Human Values 2008;34(9):8‐33.
Pearce 2000
    1. Pearce N, Sunyer J, Cheng S, Chinn S, Bjorksten B, et al. Comparison of asthma prevalence in the ISAAC and the ECRHS. European Respiratory Journal 2000;16:420‐6. - PubMed
Pinnock 2005a
    1. Pinnock H, Madden V, Snellgrove C, Sheikh A. Telephone or surgery asthma reviews? Preferences of participants in a primary care randomised controlled trial. Primary Care Respiratory Journal 2005;14:42‐6. - PMC - PubMed
Punekar 2009
    1. Punekar Y, Sheikh A. Establishing the incidence and prevalence of clinician‐diagnosed allergic conditions in children and adolescents using routinely collected data from general practices. Clinical and Experimental Allergy 2009;39(8):1209‐16. - PubMed
Shepperd 2009
    1. Shepperd S, Lewin S, Strauss S, Clarke M, Eccles MP, Fitzpatrick R, et al. Can we systematically review studies that evaluate complex interventions?. Plos Medicine 2009;6(8):e1000086. - PMC - PubMed
Simpson 2010
    1. Simpson CR, Sheikh A. Trends in the epidemiology of asthma in England: a national study of 333,294 patients. Journal of the Royal Society of Medicine 2010;103(3):98‐106. - PMC - PubMed
Tulu 2007
    1. Tulu B, Chatterjee S, Maheshewari M. Telemedicine taxonomy: a classification tool. Telemedicine Journal and e‐Health 2007;13(3):349‐58. - PubMed
Whitten 2002
    1. Whitten PS, Mair FS, Haycox A, May CR, WIlliams TL, Hellmich S. Systematic review of cost effectiveness studies of telemedicine interventions. BMJ 2002;324:1434‐7. - PMC - PubMed