• Michele Vitacca, Laura Comini, Marta Tentorio, Giuliano Assoni, Debora Trainini, Domenico Fiorenza, Roberta Morini, Gisella Bruletti, and Simonetta Scalvini.
• Pneumologia Riabilitativa, Fondazione Salvatore Maugeri, IRCCS, Lumezzane, Brescia, Italy. michele.vitacca@fsm.it
• J Telemed Telecare. 2010 Jan 1; 16 (2): 83-8.

AbstractPatients with amyotrophic lateral sclerosis (ALS) need a care programme as the disease progresses. We used telemedicine-assisted integrated care (TAIC) in 40 patients with ALS, for a mean duration of 8.6 months (range 1-12). A nurse-tutor played the key role, supported by respiratory physicians, neurologists and psychologists. Each patient used a portable pulse oximeter during the daily telephone contacts to assess clinical/oxygen variations. Patients also completed a satisfaction questionnaire. During the study period, each patient used TAIC at least five times per month. There were 1907 scheduled telephone calls (86% of the total) and 317 unscheduled calls. Of the unscheduled calls, 84% were managed by the nurse-tutor and only 16% of them required specialist intervention. The most common item was the ALS clinical interview (58%), followed by the description of acute symptoms, cough ability and oxygenation. TAIC staff recommended 4 out of 12 emergency hospital admissions (33%) and 77% of the other hospitalizations. Patients and caregivers were extremely satisfied (79%) with the nurse assistance provided and the patients' confidence in handling their disease improved in 71% of the cases. TAIC provides a nurse-centred, home-monitoring programme that can be a useful way of following up ALS patients.

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