Professionals from the Bellvitge University Hospital (HUB) and the IDIBELL Pulmonology Research Group have launched a telecare project to monitor patients with severe asthma. It is the first time that hospital telecare for asthma care has been implemented in Catalonia.

The project has included the creation of a specific mobile application for patients. This application allows patients to access texts, images and educational videos personalized according to the condition and needs of each person; periodically communicate data on their evolution and on the use of inhalers through specific questionnaires; monitor their medication; monitor lung function with the use of a home expiratory flow (PEF) meter; receive a nutritional plan; receive recommendations and medication adjustments from the care team based on the data communicated, and contact the care team with any questions or emergencies through a messaging section.

This initiative has been deployed as a scientific study to determine whether or not, after one year, patients followed electronically have had a better evolution than those treated only in person. A total of 108 patients participate in the pilot study (54 treated with telemedicine and 54 controls, determined randomly), and its results are expected to be released in the middle of next year.

The figure of the nursing professional who is an expert in asthma plays a key role in this project since nurses have participated in training patients on the use of the application and are the reference for telematic communications between patients and the hospital.

Dr. Mariana Muñoz-Esquerre, coordinator of the Functional Asthma Unit of the Bellvitge University Hospital and principal investigator of the IDIBELL Pulmonology Research Group, highlights that “although there are already many apps on asthma, they usually only offer generic recommendations; the one in our project offers personalized information, allows the control and monitoring of the disease and, most importantly, always has a healthcare team behind it.”

Dr. Muñoz-Esquerre emphasizes that “50% of patients with severe asthma have poor control of the disease. With this project, we aim to reinforce the education and skills of patients, detect worsening symptoms early, and improve the control of comorbidities.”

For his part, expert nurse Héctor Cabrerizo points out that “while the consultation is a relatively short and occasional contact, with this app we can have more continuous contact. When a patient, in normal clinical practice, worsens between visits, we only realize it after a while; this way we will immediately have the information and will be able to react quickly.”

Héctor Cabrerizo adds that “it is also useful in the opposite direction: it will allow more spacing of visits for patients who do not have any problems.” As he highlights, “we need to overcome the typical care model and apply new resources to new challenges, which empower the patient, in a context in which there are more and more people affected and with more chronic diseases.”

This project is one of the lines of work of the IDIBELL Pulmonology Research Group, focused on highly complex chronic respiratory disease (MAC-Res). It is part of the DAIPO (Digital Transformation of Health) project of the ICS-Metropolitana Sur and has received a grant from the Col·legi Official d’Infermeres i Infermers of Barcelona. Likewise, it has recently been a finalist in the III Innovation Contest in severe asthma of the Spanish Society of Pulmonology and Thoracic Surgery (SEPAR) and has had the collaboration of the Allergology Service for the inclusion of patients with asthma treated in its consultations.

Once the project is completed, not only the improvements in disease control, treatment adherence and quality of life achieved will be assessed, but also the patients’ progress in overall knowledge of the disease itself. Once the strengths and weaknesses of the results have been evaluated, the plan is that this activity can continue within the global telecare technological framework that the Bellvitge University Hospital is currently developing.

In Catalonia, more than half a million people suffer from asthma, with an average age of 41 years, of which 54.2% are women. The most common symptoms are difficulty breathing, dry cough, feeling of pressure and wheezing in the chest. The disease can also periodically cause attacks and crises that can be very serious. It is often found associated with other chronic diseases. Although there is no cure, it can be well controlled in most cases if it is well treated and there is correct follow-up and adherence.

The Bellvitge Biomedical Research Institute (IDIBELL) is a biomedical research center created in 2004. It is participated by the Bellvitge University Hospital and the Viladecans Hospital of the Catalan Institute of Health, the Catalan Institute of Oncology, the University of Barcelona and the City Council of L’Hospitalet de Llobregat.

IDIBELL is a member of the Campus of International Excellence of the University of Barcelona HUBc and is part of the CERCA institution of the Generalitat de Catalunya. In 2009 it became one of the first five Spanish research centers accredited as a health research institute by the Carlos III Health Institute. In addition, it is part of the “HR Excellence in Research” program of the European Union and is a member of EATRIS and REGIC. Since 2018, IDIBELL has been an Accredited Center of the AECC Scientific Foundation (FCAECC).