Randomized trial of an electronic asthma monitoring system among New York City children.
OBJECTIVE
To test the efficacy of an electronic asthma monitoring system (AMS) to reduce pediatric emergency department (ED) visits and hospitalizations for asthma.


METHODS
Randomized clinical trial.


METHODS
Families of pediatric patients with asthma aged 8 to 17 years were recruited at 6 medical centers. Children were randomly assigned to the American Medical Alert Corporation pediatric AMS or a paper diary. The numbers of and costs associated with ED visits and hospitalizations for the 2 groups in the year following randomization were compared using t tests of statistical significance.


RESULTS
Of 59 children recruited to the trial, 29 were randomized to the AMS and 30 to the diary. The 2 groups were similar in demographic and clinical characteristics. During their study year, 24 AMS group members logged on a mean (SD) of 211.0 (117.3) days; 13 diary group members provided data on a mean (SD) of 136.6 (128.0) days. During the 32 months that the study was in progress, the case managers logged on a mean (SD) of 171.0 (97.2) days. Overall, 35 children had at least 1 ED visit, but only 7 children were hospitalized. The 2 groups had no statistically significant differences in the numbers of or charges associated with ED visits or hospitalizations.


CONCLUSIONS
Electronic devices are being developed to make chronic disease management easier for patients and their families, but they should not be adopted without careful study, including randomized trials, to ascertain their use, costs, and benefits.
Jacobson
Judith S
JS
Department of Epidemiology, Mailman School of Public Health, Columbia University, New York, NY 10032, USA. jsj4@columbia.edu
Lieblein
Andrea
A
Fierman
Arthur H
AH
Fishkin
Edward R
ER
Hutchinson
Vincent E
VE
Rodriguez
Luis
L
Serebrisky
Denise
D
Chau
Michelle
M
Saperstein
Arnold
A
D000293:Adolescent; D001249:Asthma / Q000188:drug therapy / Q000453:epidemiology*; D002648:Child; D004636:Emergency Service, Hospital / Q000706:statistics & numerical data; D005260:Female; D006760:Hospitalization / Q000706:statistics & numerical data; D006801:Humans; D008297:Male; D018670:Monitoring, Ambulatory; D009519:New York City / Q000453:epidemiology; D010353:Patient Education as Topic; D013686:Telemetry