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The self-management module of the mHealth system included the facility for patients to keep a daily symptom diary which included questions about their general well-being, cough and sputum production (quantity and colour), and breathlessness to allow exacerbation detection based on questions used in previous trials [ 10, 11].
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The search for prognostic lipid biomarkers of disease severity and exacerbations should allow a better understanding of the regulation of inflammation, the link between genotype and lipid imbalances and the therapeutic potential of certain lipids.
An additional three studies 33, 41, 52 provided data on the proportion of patients with at least one exacerbation allowing a combined 36,657 patients.
Patients were not allowed to have exacerbation or any change in concomitant medication for at least 4 weeks prior to the study.
A clinical audit into avoidable factors, which may influence adverse outcomes like asthma exacerbation, allows us to identify shortcomings in the process of care in relation to this adverse outcome [ 13].
This would be of particular relevance to those more at risk of exacerbations and would allow health care professionals to support and encourage the self-management of CHF in a more personalised way, whilst remotely monitoring health state in order to detect the signs of a forthcoming exacerbation.
CompEx needs to strongly mirror results seen with the severe exacerbation-validated outcome, to allow the design of clinical trials of shorter duration and that include fewer patients than trials assessing severe exacerbations.
The following intervention 'exit criteria' (in case of 'treatment failure') are being used: the maximum numbers of pulmonary exacerbations allowed in any 12 month period are either 6 episodes treated by the local clinic (as an outpatient) or 4 hospital admissions.
Telemonitoring of short-acting β-agonist (SABA) focuses on patterns of use and may allow more timely action to avert exacerbations.
Studying the inflammatory response to a single pathogenic species is likely to be more consistent and allow one to better compare colonization with exacerbation.
This will allow us to further uncover even small exacerbations in headache, which inadvertently may affect the quality of life for the individual patient, however temporary these changes may prove to be.
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