***TASK*** the task is to summarize an input biomedical literature in six sentences 
    ***INPUT*** the input is a biomedical literature 
    ***OUTPUT*** the output is the summary of an input biomedical literature in six sentences 
    ***DOCUMENTATION*** 
    ***EXAMPLES*** 
    Input: 263 participants completing a r and omised controlled trial comparing  telephone vs. face-to-face asthma consultations were asked about preferences for future review s. Qualitative analysis of data from 209 respondents identified divergent views . Clear opinions were expressed about the respective roles of the two modes of consulting ; telephone consultations were considered convenient for review ing ' well controlled ' asthma , whereas face-to-face consultations were perceived as allowing in-depth assessment of problems in those with more symptomatic asthma . Practice s may consider offering patients the choice of a telephone or face-to-face review Background : No r and omised studies have addressed whether self-management for asthma can be successfully delivered by community pharmacists . Most r and omised trials of asthma self-management have recruited participants from secondary care ; there is uncertainty regarding its effectiveness in primary care . A r and omised controlled study was undertaken to determine whether a community pharmacist could improve asthma control using self-management advice for individuals recruited during attendance at a community pharmacy . Methods : Twenty four adults attending a community pharmacy in Tower Hamlets , east London for routine asthma medication were r and omised into two groups : the intervention group received self-management advice from the pharmacist with weekly telephone follow up for 3 months and the control group received no input from the pharmacist . Participants self-completed the North of Engl and asthma symptom scale at baseline and 3 months later . Results : The groups were well matched at baseline for demographic characteristics and mean ( SD ) symptom scores ( 26.3 ( 4.8 ) and 27.8 ( 3.7 ) in the intervention and control groups , respectively ) . Symptom scores improved in the intervention group and marginally worsened in the control group to 20.3 ( 4.2 ) and 28.1 ( 3.5 ) , respectively ( p<0.001 ; difference adjusted for baseline scores = 7.0 ( 95 % CI 4.4 to 9.5 ) . Conclusions : A self-management programme delivered by a community pharmacist can improve asthma control in individuals recruited at a community pharmacy . Further studies should attempt to confirm these findings using larger sample s and a wider range of outcome measures The study objective was to describe the prospect i ve use of an interactive Patient Education and Motivation Tool ( PEMT ) placed within a pediatric emergency department ( ED ) . A touch screen computer was utilized to deliver asthma education to children and their parents/guardians during their acute asthma visit between November 2006 and April 2007 . Ninety-nine participants were enrolled in this prospect i ve non-r and omized pre — post study .  PEMT comprised three key components : screening , learning and evaluation . The tool tracked the date the system was used , user characteristics , asthma knowledge , amount of time spent on each screen , and navigational patterns of individuals using the program . The results showed that baseline asthma knowledge had positive association with age and negative association with time spent in the learning module . There was negative association between age and time spent in the learning module . Thus PEMT was effective in improving the asthma knowledge of young patients and those having lower baseline knowledge Background Asthma is a chronic lung disease in which recurrent asthma symptoms create a substantial burden to individuals and their families . At the same time the economic burden associated with asthma is considerable . Methods The cost-effectiveness study was part of a single centre prospect i ve r and omised controlled trial comparing a nurse-led telemonitoring programme to usual care in a population of asthmatic out patients . The study included 109 asthmatic out patients ( 56 children ; 53 adults ) . The duration of follow-up was 12 months , and measurements were performed at baseline , 4 , 8 , and 12 months . Patients were asked to transfer their monitor data at least twice daily and by judging the received data and following a stepwise intervention protocol a nurse was able to act as the main caregiver in the intervention group . In both groups the EQ-5D and the SF-6D were used to obtain estimates of health state utilities . One year health care costs , patient and family costs , and productivity losses were calculated . The mean incremental costs were weighted against the mean incremental effect in terms of QALY . Results The study population generally represented mild to moderate asthmatics . No significant differences were found between the groups with regard to the generic quality of life . Overall , the mean health care costs per patient were higher in the intervention group than in the control group . The intervention costs mainly caused the cost difference between the groups . The intervention costs the society € 31,035/QALY gained with regard to adults and with regard to children € 59,071/QALY gained . Conclusion If the outcome is measured by generic quality of life the nurse-led telemonitoring programme is of limited cost-effectiveness in the study population . From the societal perspective the probability of the programme being cost-effective compared to regular care was 85 % at a ceiling ratio of € 80,000/QALY gained among the adults and 68 % among the children . A decrease in the price of the asthma monitor will substantial increase the probability of the programme to be cost-effective . Trial registration Number : BACKGROUND Attendance for routine asthma review s is poor . A recent r and omised controlled trial found that telephone consultations can cost-effectively and safely enhance asthma review rates ; however , concerns have been expressed about the generalisability and implementation of the trial 's findings . AIM To evaluate the effectiveness of a telephone option as part of a routine structured asthma review service . DESIGN OF STUDY Phase IV controlled before- and -after implementation study . SETTING A large UK general practice . METHOD Using existing administrative groups , all patients with active asthma ( n = 1809 ) received one of three asthma review services : structured recall with a telephone-option for review s versus structured recall with face-to-face-only review s , or usual-care ( to assess secular trends ) . Main outcome measures were : proportion of patients with active asthma review ed within the previous 15 months  ( Quality and Outcomes Framework target ) , mode of review , enablement , morbidity , and costs to the practice . RESULTS A routine asthma review was provided for 397/598 ( 66.4 % ) patients in the telephone-option group compared with 352/654 ( 53.8 % ) in the face-to-face-only review group : risk difference 12.6 % ( 95 % confidence interval [ CI ] = 7.2 to 17.9 , P<0.001 ) . The usual-care group achieved a review rate of 282/557 ( 50.6 % ) . Morbidity was equivalent in the three groups ; however , enablement ( P = 0.03 ) and confidence ( P = 0.007 ) in asthma management were greater in the telephone-option versus face-to-face-only group . The cost per review achieved by providing the telephone-option service was lower than the face-to-face-only service ( 10.03 pounds versus 12.74 pounds , mean difference 2.71 pounds ; 95 % CI = 1.92 to 3.50 , P<0.001 ) ; usual-care costs were 11.85 pounds per review achieved . CONCLUSION Routinely offering telephone review s  cost-effectively increased asthma review rates , enhancing patient enablement and confidence with management , with no detriment to asthma morbidity . Practice s should consider a telephone option for their asthma review service RATIONALE Asthma treatment might improve when inhaled steroids are titrated on airway inflammation . Fractional exhaled nitric oxide ( FeNO0.05 ) , a marker of eosinophilic airway inflammation , can be measured at home . OBJECTIVES We assessed daily FeNO0.05 telemonitoring in the management of childhood asthma .  METHODS Children with atopic asthma ( n = 151 ) were r and omly assigned to two groups : FeNO0.05 plus symptom monitoring , or monitoring of symptoms only . All patients scored asthma symptoms in an electronic diary over 30 weeks ; 77 received a portable nitric oxide ( NO ) analyzer . Data were transmitted daily to the coordinating centers . Patients were phoned every 3 weeks and their steroid dose was adapted according to FeNO0.05 and symptoms , or according to symptoms . Children were seen at 3 , 12 , 21 , and 30 weeks for examination and lung function testing . The primary end point was the proportion of symptom-free days in the last 12 study weeks . MEASUREMENTS AND MAIN RESULTS Telemonitoring was feasible with reliable FeNO0.05 data for 86 % of days , and valid diary entries for 79 % of days . Both groups showed an increase in symptom-free days , improvement of FEV1 and quality of life , and a reduction in steroid dose . None of the changes from baseline differed between groups . The difference in symptom-free days over the last 12 weeks was 0.3 % ( P = 0.95 ; 95 % confidence interval , -10 to 11 % ) . There was a trend for fewer exacerbations in the FeNO0.05 group . CONCLUSIONS Thirty weeks of daily FeNO0.05 and symptom telemonitoring was associated with improved asthma control and a lower steroid dose . We found no added value of daily FeNO0.05 monitoring compared with daily symptom monitoring only A r and omized , controlled trial was conducted to assess the effectiveness of Blue Angel for Asthma Kids , an Internet-based interactive asthma educational and monitoring program , used in the management of asthmatic children . One hundred sixty-four ( n = 164 ) pediatric patients with persistent asthma were enrolled and r and omized into two study groups for a 12-week controlled trial . The intervention group had 88  participants who were taught to monitor their peak expiratory flows ( PEF ) and asthma symptoms daily on the Internet . They also received an interactive response consisting of a self-management plan from the Blue Angel monitoring program . The control group had 76 participants who received a traditional asthma care plan consisting of a written asthma diary supplemented with instructions for self-management . Disease control was assessed by weekly averaged PEF values , symptom scores , and asthma control tests . Adherence measures were assessed by therapeutic and diagnostic monitoring . Outcome was assessed by examining quality of life and retention of asthma knowledge . The data were analyzed by comparing results before and after the trial . At the end of trial , the intervention group decreased nighttime ( -0.08 + /- 0.33 vs. 0.00 + /- 0.20 , p = 0.028 ) and daytime symptoms ( -0.08 + /- 0.33 vs. 0.01 + /- 0.18 , p = 0.009 ) ; improved morning ( 241.9 + /- 81.4 vs. 223.1 + /- 55.5 , p = 0.017 ) and night PEF ( 255.6 + /- 86.7 vs. 232.5 + /- 55.3 , p = 0.010 ) ; increased adherence rates ( p < 0.05 ) ; improved well-controlled rates ( 70.4 % vs. 55.3 % , p < 0.05 ) ; improved knowledge regarding self-management ( 93.2 % vs. 70.3 % , p < 0.05 ) ; and improved quality of life ( 6.5 + /- 0.5 vs. 4.3 + /- 1.2 on a 7-point scale , p < 0.05 ) when compared with conventional management . The Internet-based asthma telemonitoring program increases selfmanagement skills , improves asthma outcomes , and appears to be an effective and well-accepted technology for the care of children with asthma and their caregivers OBJECTIVES To test the hypothesis that reinforcement of the advice given at the time of discharge from the emergency department by telephone consultation would improve asthma outcomes . METHODS A r and omized controlled trial of the parents of 310 children who had been discharged from the emergency department with asthma was undertaken . The parents were r and omized to receive either st and ard care ( 155 children ) or st and ard care plus education by telephone ( 155 children ) from a trained asthma educator . Symptoms , parental asthma knowledge , parental quality of life and use of asthma action plans and preventer therapy were collected at baseline and 6 months later . The primary measure was days of wheeze in last 3 months ; intermediate measures were regular use of preventer medications , possession and use of written asthma action plan , parental asthma knowledge scores and parental quality of life scores . RESULTS A total of 266 parents ( 136 intervention ) completed the follow-up question naires after 6 months . Both groups showed similar symptoms and process measures at baseline , apart from more regular use of preventer medication in the control children . At follow up , the intervention group children were significantly more likely than controls to possess ( 87.5 % vs 72.3 % ; P = 0.002 ) a written asthma action plan . Possession of action plans increased from baseline in the intervention group but tended to decrease in the control group . Use of action plans was greater in the intervention group but decreased from baseline in both groups . Both intervention and control groups showed significant decreases in asthma symptoms . CONCLUSIONS Reinforcement by telephone consultation did not improve the primary outcome of wheeze in the last 3 months . However , it increased the possession and regular use of written asthma action plans in the intervention group OBJECTIVE . Many children are brought to the pediatric emergency department ( ED ) with acute asthma symptoms . Emergency asthma care is costly , and many ED visits may be preventable . Families often do not 
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There was , however , a significant reduction in hospitalisations over a 12-month period : OR 0.21 ( 95 % CI 0.07 to 0.61 ) , the effect being most marked in people with more severe asthma managed predominantly in secondary care setting s. AUTHORS ' CONCLUSIONS Telehealthcare interventions are unlikely to result in clinical ly relevant improvements in health outcomes in those with relatively mild asthma , but they may have a role in those with more severe disease who are at high risk of hospital admission .