Internet-based home asthma telemonitoring: can patients handle the technology?

Chest. 2000 Jan;117(1):148-55. doi: 10.1378/chest.117.1.148.


Study objective: To evaluate the validity of spirometry self-testing during home telemonitoring and to assess the acceptance of an Internet-based home asthma telemonitoring system by asthma patients.

Design: We studied an Internet-based telemonitoring system that collected spirometry data and symptom reports from asthma patients' homes for review by physicians in the medical center's clinical information system. After a 40-min training session, patients completed an electronic diary and performed spirometry testing twice daily on their own from their homes for 3 weeks. A medical professional visited each patient by the end of the third week of monitoring, 10 to 40 min after the patient had performed self-testing, and asked the patient to perform the spirometry test again under his supervision. We evaluated the validity of self-testing and surveyed the patients attitude toward the technology using a standardized questionnaire.

Setting: Telemonitoring was conducted in patients' homes in a low-income inner city area.

Patients: Thirty-one consecutive asthma patients without regard to computer experience.

Measurement and results: Thirty-one asthma patients completed 3 weeks of monitoring. A paired t test showed no difference between unsupervised and supervised home spirometry self-testing. The variability of FVC (4.1%), FEV(1) (3. 7%), peak expiratory flow (7.9%), and other spirometric indexes in our study was similar to the within-subject variability reported by other researchers. Despite the fact that the majority of the patients (71%) had no computer experience, they indicated that the self-testing was "not complicated at all" or only "slightly complicated." The majority of patients (87.1%) were strongly interested in using home asthma telemonitoring in the future.

Conclusions: Spirometry self-testing by asthma patients during telemonitoring is valid and comparable to those tests collected under the supervision of a trained medical professional. Internet-based home asthma telemonitoring can be successfully implemented in a group of patients with no computer background.

Publication types

  • Comparative Study
  • Research Support, Non-U.S. Gov't

MeSH terms

  • Adult
  • Aged
  • Asthma / physiopathology*
  • Cost-Benefit Analysis
  • Female
  • Home Care Services
  • Humans
  • Internet*
  • Male
  • Middle Aged
  • Patient Compliance
  • Peak Expiratory Flow Rate
  • Reproducibility of Results
  • Socioeconomic Factors
  • Spirometry / methods*
  • Surveys and Questionnaires
  • Telemetry / economics
  • Telemetry / methods*
  • Urban Population