Irvin Mayers, M.D., Professor of Medicine at the University of Alberta in Edmonton, Canada, created an interactive online asthma management program that allows a Certified Asthma Educator to communicate daily with patients, provide feedback and assist patients with asthma management.
"One of the problems in Canada is geographic barriers-many people don't have access to large urban asthma education programs, and they can really benefit from an online program," said Dr. Mayers. "But even our urban patients often have barriers to accessing physicians, because there aren't enough generalists. This program allows them to be treated using the most up-to-date guidelines no matter where they live, and to manage their asthma with minimal physician intervention. The program isn't meant to replace doctors, but to complement their ability to treat patients who are chronically ill."
In the pilot study, patients' lung function was measured at the beginning of the study and after two months of using the secure website. During the two-month period, patients were encouraged to use the website to enter their peak flow rates (a measure of their lung function) and symptom information. They were able to ask the asthma educator questions, get asthma information and fill out online questionnaires about their quality of life. The 63 patients enrolled in the study used the website an average of 33 times during the study, and entered their peak flow data a total of 27 times.
"Several studies have shown that physicians underestimate asthma severity in their patients," Dr. Mayers said. "This online program allows patients to input their symptoms and peak flow rates, and forces them to recognize whether their asthma is controlled or not." Their symptoms and peak flow rates are graphed over a two-week period, and patients receive recommendations about whether they should change their therapy. "The asthma educator provides human oversight to these recommendations," Dr. Mayers said. "It's a dynamic asthma management program."
While this study did not examine whether the patients' asthma improved because of the online program, Dr. Mayers is now setting up a randomized, controlled study that will look at whether the online program affects asthma attack frequency and utilization of healthcare.