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          "en" => "<p id="spar0005" class="elsevierStyleSimplePara elsevierViewall">Sections and content included in the proposed tool to support severe asthma patients while preparing for their remote follow-up visits with the specialists&#46;</p> <p id="spar0010" class="elsevierStyleSimplePara elsevierViewall">ACT&#8482;&#58; Asthma Control Test&#59; cACT&#8482;&#58; Childhood Asthma Control Test&#46;</p>"
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    "textoCompleto" => "<span class="elsevierStyleSections"><p id="par0005" class="elsevierStylePara elsevierViewall">The impossibility of face-to-face follow-up visits during the COVID-19 pandemic and the need to provide patients with ongoing medical care led to an increase in remote follow-up consultations for the management of patients with chronic diseases such as severe asthma<a class="elsevierStyleCrossRefs" href="#bib0005"><span class="elsevierStyleSup">1&#8211;5</span></a>&#46; As a consequence&#44; today there is a new reality in severe asthma management&#44; with a prominence of remote visits as a good alternative for ensuring that follow-up is compatible with work-life balance while ensuring the quality and continuity of healthcare&#46;</p><p id="par0010" class="elsevierStylePara elsevierViewall">The future of telemedicine in respiratory conditions in Europe has started to become a reality&#46; Various scientific societies are already advocating for its use<a class="elsevierStyleCrossRefs" href="#bib0030"><span class="elsevierStyleSup">6&#44;7</span></a>&#44; supporting the development of strategies and initiatives for implementing remote consultations for patients with severe asthma<a class="elsevierStyleCrossRefs" href="#bib0015"><span class="elsevierStyleSup">3&#44;8</span></a>&#46; However&#44; to ensure that severe asthma patients receive the quality care they need&#44; tools to improve remote follow-up consultations must be developed&#46; These tools must focus on training patients on their specific educational needs while also enabling healthcare professionals to analyze the disease&#8217;s progress in this new scenario&#46;</p><p id="par0015" class="elsevierStylePara elsevierViewall">In this context&#44; a detailed analysis of the different perspectives on COVID-19&#8217;s impact on patients with severe asthma and the healthcare provided to these patients during the pandemic was performed&#46; This analysis detected a specific need regarding how to ease the transition to a hybrid model that combines face-to-face and remote follow-up visits&#46; It also highlighted the need to set up training programs to ensure quality care for patients&#44; who need to be prepared in advance before receiving medical care in this new manner&#46;</p><p id="par0020" class="elsevierStylePara elsevierViewall">To this end&#44; a multidisciplinary group of nine specialists with expertise in severe asthma &#40;allergists&#44; pulmonologists&#44; and specialist nurses from severe asthma units&#41; developed a tool geared towards improving remote follow-up consultations with a particular emphasis on patient needs&#46; This tool has been validated in patients to ensure its comprehensibility and evaluate their willingness to use this tool&#46; For this purpose&#44; eight cognitive interviews with patients from different geographical backgrounds were conducted&#46; All patients were diagnosed with severe asthma &#40;more than two years since diagnosis&#41; and had previous experience with remote consultations&#46; The results were very favorable&#59; the subjects expressed their wish that this type of material could soon be implemented in clinical practice&#46;</p><p id="par0025" class="elsevierStylePara elsevierViewall">The final version of the tool&#44; called onasm&#64;&#44; is available in its English version at the Supplementary material&#46; It is structured in three blocks &#40;<a class="elsevierStyleCrossRef" href="#fig0005">Fig&#46; 1</a>&#41;&#58;<ul class="elsevierStyleList" id="lis0005"><li class="elsevierStyleListItem" id="lsti0005"><span class="elsevierStyleLabel">1</span><p id="par0030" class="elsevierStylePara elsevierViewall"><span class="elsevierStyleBold">General considerations</span> on how to conduct a remote follow-up visit&#44; underlining the importance of remote consultation&#44; as well as the need for the patient to prepare for the remote visit in advance and commit to keeping the appointment to maximize the effectiveness of this type of consultation&#46;</p></li><li class="elsevierStyleListItem" id="lsti0010"><span class="elsevierStyleLabel">2</span><p id="par0035" class="elsevierStylePara elsevierViewall"><span class="elsevierStyleBold">Data log for patients</span> to record the information that the healthcare professional will elicit from them during the remote visit &#40;e&#46;g&#46;&#44; treatment regimen&#44; degree of compliance&#44; visits to the emergency room&#44; at-home asthma attacks resolved with rescue medication&#44; and the need for oral corticosteroids or antibiotics&#41; to make the visit more productive&#44; simple&#44; and effective&#46;</p></li><li class="elsevierStyleListItem" id="lsti0015"><span class="elsevierStyleLabel">3</span><p id="par0040" class="elsevierStylePara elsevierViewall"><span class="elsevierStyleBold">Advice to improve asthma control</span>&#44; mainly focused on the importance of following the advice given by the medical team and leading a healthy lifestyle&#46;</p></li></ul></p><elsevierMultimedia ident="fig0005"></elsevierMultimedia><p id="par0045" class="elsevierStylePara elsevierViewall">Moreover&#44; in line with the European Respiratory Society Guidelines and the Global Strategy for Asthma Management and Prevention &#40;GINA&#41; recommendations for correct asthma monitoring and management&#44; the tool includes the Asthma Control Test &#40;ACT&#8482;&#41; for adults and the version for children &#40;cACT&#8482;&#41; to be completed by the parents of pediatric patients&#46;</p><p id="par0050" class="elsevierStylePara elsevierViewall">This eminently practical tool empowers severe asthma patients by enabling them to understand the relevance of remote follow-up visits&#44; learn about their dynamics&#44; and prepare for them in advance by compiling all the information they should know and will be asked for during the remote consultation in a single document&#59; this will also help them in face-to-face visits&#46; In addition&#44; remote follow-up visits allow for reducing hospital visits and empower the patient by giving them greater time flexibility and favoring work-life balance&#46;</p><p id="par0055" class="elsevierStylePara elsevierViewall">One indicator of maturity in the remote patient care field is the amount of information available&#44; its format and structure&#44; and how flexibly it can be adapted to each patient&#8217;s needs<a class="elsevierStyleCrossRefs" href="#bib0045"><span class="elsevierStyleSup">9&#44;10</span></a>&#46; Information can be leveraged to help guarantee the patient&#8217;s constancy and engagement<a class="elsevierStyleCrossRef" href="#bib0055"><span class="elsevierStyleSup">11</span></a>&#44; which is highly important in chronic diseases&#46; Targeting remote care in a vulnerable population requires creating a climate of trust in the efficacy&#44; safety&#44; and confidentiality of the telemedicine system in which patients feels comfortable and well-informed<a class="elsevierStyleCrossRef" href="#bib0055"><span class="elsevierStyleSup">11</span></a>&#46;</p><p id="par0060" class="elsevierStylePara elsevierViewall">In asthma&#44; remote follow-up visits may offer benefits in terms of improving disease control&#44; health-related quality of life &#40;HR-QoL&#41;&#44; exacerbations&#44; hospital admissions&#44; exercise capacity&#44; and health resource use &#40;including visits to the emergency room&#41;<a class="elsevierStyleCrossRef" href="#bib0060"><span class="elsevierStyleSup">12</span></a>&#46; To date&#44; the great heterogeneity in methodology&#44; variables&#44; and patient populations analyzed in telemedicine studies has rendered it difficult to draw clear conclusions about their efficacy and feasibility in asthma&#44; particularly in long-term follow-up<a class="elsevierStyleCrossRefs" href="#bib0020"><span class="elsevierStyleSup">4&#44;13&#44;14</span></a>&#46; Also&#44; although telemedicine can be cost-effective&#44; cost-efficient&#44; and successful<a class="elsevierStyleCrossRef" href="#bib0070"><span class="elsevierStyleSup">14</span></a>&#44; there are barriers to its widespread use&#44; such as the lack of a clear legislative environment&#44; a scarcity of information&#44; organizational and technical constraints&#44; and resistance from potential users<a class="elsevierStyleCrossRefs" href="#bib0015"><span class="elsevierStyleSup">3&#44;9&#44;15</span></a>&#46; Stakeholder acceptance&#44; integration into the electronic health record&#44; and cost-effectiveness are keys to success<a class="elsevierStyleCrossRef" href="#bib0060"><span class="elsevierStyleSup">12</span></a>&#46; Work is now under way to identify factors that will accelerate the implementation of telemedicine in respiratory medicine<a class="elsevierStyleCrossRefs" href="#bib0015"><span class="elsevierStyleSup">3&#44;8</span></a> and contingency plans are being developed to include it as a standard of care for asthma patients<a class="elsevierStyleCrossRef" href="#bib0005"><span class="elsevierStyleSup">1</span></a>&#46;</p><p id="par0065" class="elsevierStylePara elsevierViewall">In this context&#44; this initiative and the onasm&#64; tool seek to ease the transition to a hybrid care model&#44; making patients aware of the importance of non-face-to-face visits&#46; This will enable them to adopt the right habits for preparing for remote follow-up visits&#44; promoting fluent communication with the healthcare professional and more efficient appointments while also ultimately working to the benefit of the healthcare system &#40;improved quality of life and patient satisfaction&#44; greater flexibility&#44; and optimization of time and resources&#44; to name but a few factors&#41;<a class="elsevierStyleCrossRefs" href="#bib0020"><span class="elsevierStyleSup">4&#44;13&#44;14</span></a>&#46; Informed and humanized remote healthcare can facilitate the process of transforming care practice and consequently the care provided to severe asthma patients&#46;</p><span id="sec0005" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0005">Funding</span><p id="par0070" class="elsevierStylePara elsevierViewall">This project was funded by <span class="elsevierStyleGrantSponsor" id="gs0005">GSK&#44; Spain</span>&#46;</p></span><span id="sec0010" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0010">Conflict of interests</span><p id="par0075" class="elsevierStylePara elsevierViewall">All authors declare that they have received financial support from GSK for developing the material described in the present work&#46;</p><p id="par0080" class="elsevierStylePara elsevierViewall">Outside the submitted work&#58; <span class="elsevierStyleBold">Lorena Soto-Retes</span> reports personal payment or honoraria for lectures&#44; presentations&#44; speakers&#8217; bureaus&#44; manuscript writing&#44; or educational events and support for attending meetings and&#47;or travel from GSK&#44; AstraZeneca&#44; Novartis&#44; Sanofi&#44; Stallergenes Greer&#44; HAL Allergy Group&#44; and Allergy Therapeutics PLC&#46;</p><p id="par0085" class="elsevierStylePara elsevierViewall"><span class="elsevierStyleBold">Silvia Sanchez-Garc&#237;a</span> declares that she has received lecture fees from ALK-Abell&#243;&#44; LETI Pharma&#44; and GSK&#59; consulting fees from GSK&#59; and financial support for research from AstraZeneca&#46;</p><p id="par0090" class="elsevierStylePara elsevierViewall"><span class="elsevierStyleBold">Eusebi Chiner</span> declares that he has received payment or honoraria for lectures&#44; presentations&#44; speakers bureaus&#44; manuscript writing&#44; or educational events from AstraZeneca&#44; 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David D&#237;az&#44;</span> and <span class="elsevierStyleBold">Irina Bobolea</span> declare that they have no other conflict of interest outside the submitted work&#46;</p></span></span>"
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        "texto" => "<p id="par0115" class="elsevierStylePara elsevierViewall">We would like to thank Nerea Toro and Ana Fern&#225;ndez from Adelphi Targis S&#46;L&#46; and Beatriz Velasco&#44; M Guadalupe S&#225;nchez&#44; and Monica Pantin from GSK for the support provided in the conceptualization of the material&#46;</p><p id="par0120" class="elsevierStylePara elsevierViewall">Editorial support &#40;writing assistance&#41; was provided by Nerea Toro and Ana Fern&#225;ndez from Adelphi Targis S&#46;L&#46; and was funded by GSK&#46;</p><p id="par0125" class="elsevierStylePara elsevierViewall">We would like to thank the severe asthma patients and the parents&#47;legal guardians of the minors who participated in this project for their cooperation&#46;</p>"
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Vol. 223. Núm. 3.
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Vol. 223. Núm. 3.
Páginas 188-191 (marzo 2023)
Correspondence
DOI: 10.1016/j.rceng.2023.01.004
Remote visits for severe asthma patients after the COVID-19 pandemic: how to address the challenge?
Visitas a distancia para los pacientes con asma grave tras la pandemia de COVID-19: ¿cómo afrontar el reto?
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S. Sánchez-Garcíaa,
Autor para correspondencia
ssanchez@salud.madrid.org

Corresponding author.
, L. Soto-Retesb, E. Chinerc, C. Cisnerosd, Working Group 1
a Allergy Department, Hospital Infantil Universitario Niño Jesús, Madrid, Spain
b Allergy and Pneumology Department, Hospital de la Santa Creu i Sant Pau, Sant Pau Biomedical Research Institute (IIB Sant Pau), Autonomous University of Barcelona (UAB), Barcelona, Spain
c Pneumology Section, Hospital Universitari San Juan d’Alacant, Alicante, Valencia, Spain
d Pulmonology Department, Hospital Universitario de la Princesa, Instituto de Investigación Biomédica La Princesa (IP), Madrid, Spain
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