Page 103 - Comprehensive treatment of patients with glucocorticoid-dependent severe asthma

Introduction
Information and Communication Technology (ICT) plays an essential role in supporting daily life in today’s digital society [1;2]. In health care, ICT has the potential to enhance the quality of care in the management of patients with chronic diseases, to improve adherence with therapy and allowing early detection of exacerbations by continuously monitoring and providing feedback to the patient [3]. Internet-based strategies have been shown to be beneficial in the management of a variety of chronic diseases such as hypertension [4], HIV [5] and chronic heart failure [6] by enabling patient empowerment and behavior change [7;8]. Moreover, there is an increasing demand from patients for using internet applications in the management of their diseases [9]. Since many of these aspects are also relevant for patients with a chronic respiratory disease, there might be a role for ICT support in the management of patients with asthma.
According to the current asthma guidelines, treatment strategies should target minimization of symptoms, optimization of lung function and prevention of exacerbations with few medication related side-effects [10]. However, despite wide availability of effective therapies for asthma, a considerable number of patients do not manage to achieve these proposed targets and experience a profound burden of disease [11;12] with a significant impact on their quality of life and on society as a whole [13]. The use of ICT in the management of patients with asthma could potentially help to overcome some of the barriers at the patient, professional and organizational level which hamper the effectiveness of conventional asthma therapies.
Firstly, ICT might empower patients with the tools and skills to become adequate self-managers and thereby gain control over their disease. For patients with asthma this includes self-monitoring (for example lung function), being able to detect and respond to symptom worsening, possibilities to tailor medication to their individual needs, and the ability to easily contact a professional. Secondly, health professionals may find ICT useful in order to interactively support patients’ self-management, establishing a patient- professional partnership. Thirdly, at the organizational level of healthcare, ICT might enable proactive care, for example by providing easy to use and
Telemanagement in asthma
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