The effectiveness of telemedicine methods in the follow-up of asthma in the COVİD-19 pandemic process

Background: Telemedicine is a health service that provides diagnosis, treatment evaluation, preventive medicine by using information and communication technologies between distant places and aims to improve the health of individuals and society. COVID-19 due to the virus called nCOV-19, which emerged in late 2019 social restrictions were applied during the pandemic process. İn this process especially having chronic illness people could not go to hospitals and their follow-up became a problem. Through remote communication and information technologies in the follow-up of asthma patients there is a need for studies on the effectiveness of using telemedicine methods is seen. Aim: By providing remote monitoring of our patients who are followed up by us, COVID-19 reducing the admissions to hospitals with high exposure risk is targeted. With the use of remote communication channels, it is aimed to increase patient-physician cooperation, and to ensure effective disease control of patients without applying to a hospital. Material and Methods: We included 328 patients between the ages of 18-65, whose diagnosis of asthma was confirmed by pulmonary function tests. Prospective clinical evaluation of the cases participating in the study and evaluation of the scales were performed by a single physician with telemedicine applications at least 3 times. In our study, as the control group, the complaints, findings, and symptoms, medications, personal history, family history and AcT results of asthma patients were taken from hospital records during the 1-year period before the pandemic period were used. File scanning covers the period between 31/06/2020 and 01/02/2020. Results: When the current data of the participants were compared with the face- to-face data before follow-up with telemedicine, no statistically significant difference was found (p> 0.05). Although there was a slight decrease in ACT scores during the follow-up, it was not statistically significant (p> 0.05). A statistically significant difference was found in severe persistent asthma as a result of the comparison of the ACT results of the participants in follow-up according to the disease severity (p <0.05). In our study, when the effect of the presence of comorbidity on ACT results in follow-up was examined, statistically significant results were obtained (p <0.05). Discussion and Conclusion: The fact that the data obtained as a result of asthma follow-ups with telemedicine methods did not show statistically significant difference suggests that telemedicine methods can be an alternative to face-to-face interviews. It is observed that ACT scores tend to decrease over time. This situation is important in that it predicts that follow-ups should not be continued with telemedicine. When monitoring of severe persistent asthma with telemedicine methods is planned, symptom follow-up and questionnaires based on patient statement alone are not sufficient. The cormorbidities of our patients disrupt the control of asthma. A multidisciplinary approach is recommended with evaluation of comorbidities, regulation of treatments, evaluation of risk factors or, if necessary, tele-consultation from additional disease-related specialties. As a result, it is predicted that telemedicine will have an important place in disease control since asthma is a disease that requires close monitoring. Disease follow- up with telemedicine is predicted to be a good alternative to traditional face-to- face follow-ups in selected patient groups. Our study also supports this situation. Keywords: Asthma, Tele-medicine, Asthma Control