Monitoring COPD and asthma: technological developments in the

IMCA II Project

Enric Duran

Municipal Institut of Medical Research (IMIM)

Workshop on Health Examination SurveysLuxembourg, 9 -11 April 2008

IMCA IIWorking Packages overview

• WP 1: Coordination of the project.

• WP 2: Dissemination of the results.

• WP 3: Evaluation of the project.

• WP 4: Indicators from routine database.

• WP 5: Indicators from international research studies.

• WP 6: HES Feasibility Study

Respiratory Health Survey in the Elderly

HES Feasibility StudyObjectives

• To assess the feasibility of using Motohealth system as a tool for performing interviews and measurements at home in the context of large scale respiratory surveys at national and international level.

• To evaluate to what extent the Motohealth system can improve response rates to questionnaires, the acceptability of measurements performance and biological samples collection when the measurements are performed at home in comparison to other settings such as a primary health care centre.

MethodologyStudy design: randomized controlled trial

Random sampleN=250

From small GA

Group AN=125

Fiedwork at home

Group BN=125

Fieldwork at the PCC

(Model A)Model B

MethodologyStudy design and population

• Which model will perform each country?

– Spain has choosen Model A.

– Sweden, Germany, Italy (Pisa &Roma) have to decide which model they choose.

– Other countries may considerer to perform the study with funding available: France, Poland, Norway and Finland.

– Other countries despite funding difficulties can explore ways of making it possible (national funding or helping them to obtain funding).

MethodologyTechnology and communication system

MOTOHEALTH System

MethodologyTechnology and communication system

(MOTOHEALTH)

• MOTOHEALTH is a tool which integrates questionnaire design, field work management, measurements performance, data collection and transmission on line with high eficiency and quality reducing costs and time for data analysis.

MethodologyTechnology and communication system

(MOTOHEALTH)

• Is an integrated mobile monitoring system.

• Allows remote monitoring of chronic patients or healthy individuals.

• Transmits the data through wireless communication (GPRS) in a secure mode to a central repository server.

• Professionals review the data and take decisions accordingly to patient/individual situation.

The system integrates three main applications:

• Backend Application (BEA): this is the application for study administration, importing individuals to the system and the administration

of professionals involved in the study.

• Survey Application (SVA): this is the application administered by the field worker for the measurements performance and questionnaires completion at individuals home.

• Geographic Location Application (GLA): this is the application that facilitates the work of the phone operators for the the individuals scheduling visits according to a geographical area.

MethodologyTechnology and communication system

(MOTOHEALTH)

MethodologyTechnology and communication system

Wireless sensors, handset/computer, call center, central server

LoginLogin ( https://linkcare.clinic.ub.es/mhworld/ )

MethodologyTechnology and communication system

Acces to MOTOHEALTH

Key professionals involved and roles

SM

Phone operator

Field worker

Study Manager

PC portàtil

Overview of the fieldwork materials and tools?

Study manager SM

MethodologyMeasurements performed and sensors

characteristics

• Spirometry (NDD Easy One Model 2001).

• Blood pressure monitor UA -767BT (A&D Medical).

• Pulse-oximetry (NONIN 4000 Avant Bluetooth).

• Weight (A&D - Medical UC-321PL).

• Height (Laser).

• Blood sample: Hemograme, Cholesterol, C-Reactive Proteine and Creatinine.

Study Manager and human resources

4 Field workers

2 Phone operators

1 Study manager

1 Pediatric nurse

FW

PO

PN

SM

FW

FW

FW PO

HES Feasibility Study in

Barcelona

HES Feasibility Study in

BarcelonaBarcelona option:Barcelona option:

SM

Field worker activities

Participant

Confirm visit

Consent form

Questionnaire & measurements

Consent formQuestionnaire & measurements

Study information

Study information

Synchronize

Field Worker

Synchronize

Interview results

Phone operator activities

Consent form

Participant

Schedule a visit Brief Questionnaire

Questionnaire & measurements

Check participant’s data

Phone Operator

Study information

MethodologyQuestionnaires selected (Adults & Children)

• Adults questionnaire: GA2LEN screening quetionnaire.– 21 questions.– Translated to four languages or more.

• Children’s questionnaire: ISAAC II protocol (selected questions):

– 32 questions.

– Translated to four languages or more.

MethodologyConsent Form

• Which are the options for all individuals?

– A) The questionnaire and all described measurements.

– B) The questionnaire and all marked measurements:

– Weight and height

– Spirometry

– Pulse-oximetry

– Blood pressure

– Blood extraction

– C) Only the questionnaire.– Blood extraction

What we expect from the technology used in this study?

MOTOHEALTH

System

Web IMCA: www.imca.cat