TELEMEDICINE MAY FAIL IF IT IS NOT ADAPTED TO PATIENTS

Introduction: Asthma is one of the most prevalent chronic diseases of the respiratory system, assuming an important health problem in times of exacerbation and poor control of the disease. In most of the diagnosed cases, the habitual monitoring and knowledge of the disease by the patient helps to considerably reduce the number of seizures and the associated symptomatology. However, several factors can mask the correct control of asthma, such as the effect according to seasonality, the asymptomatic situation in inter-crisis periods or even pre-established medical monitoring patterns without knowing the patient's current situation. Telemedicine is a tool that allows to interact remotely with patients, offering the possibility of objectifying the control of the pathology and even modifying treatment guidelines. Today, where technological development is a reality, this possibility has ceased to be a utopia to become another option for medical monitoring. Objective: To compare the degree of control between asthmatic patients with telematic follow-up and patients without telematic followup. Method: We conducted a prospective, randomized, triple-blind study in a population of asthmatic patients, usually followed up in the Pneumology Clinics of the University Hospital Complex of Albacete, using a digital platform accessible through a connection to the network (computers / smartphones). ), which allow the patient to offer the doctor who follows him basic information on a daily basis about the control of his disease. Results: 46 subjects participated (25 study group and 21 control group). The pharmacological completion has been higher than 95% in those who have used the system assiduously. The Peak flow of the study patients suffers an increase of 7% with respect to the initial values. More than 50% of patients had increased their treatment before entering the study, since their inclusion in the study none had to increase treatment. Even 25% have decreased the treatment dose. They have improved their level according to the base treatment in 32% of the patients. At three months only 26% of the patients in the study group and 10% of the control group complied with the data entry even after the notices that were issued from the portal, so despite the good results it was decided to suspend the study , warning patients. Conclusions: The medium-long term monitoring of the programs through telemedicine is difficult. It has to be an adaptation of telemedicine to patients and vice versa.