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[Effectiveness of Telemonitoring Intervention in Children and Adolescents with Asthma: A Systematic Review and
Youjin Jung1,2, Jimin Kim1, Dong Ah Park3
1National Evidence-Based Healthcare Collaborating Agency, Seoul, Korea.
Insights
Telemonitoring (TM) did not significantly improve asthma control or reduce exacerbations in children and adolescents compared to usual care. However, TM may enhance medication adherence and self-management support for pediatric asthma patients.
Area of Science:
- Pediatric Respiratory Medicine
- Digital Health Interventions
- Evidence-Based Practice
Background:
- Asthma is a prevalent chronic respiratory condition in children and adolescents.
- Effective self-management strategies are crucial for controlling pediatric asthma.
- Telemonitoring (TM) offers a potential avenue for enhancing asthma care delivery.
Purpose of the Study:
- To evaluate the effectiveness of telemonitoring (TM) in managing pediatric and adolescent asthma.
- To synthesize evidence from randomized controlled trials (RCTs) on TM for asthma.
Main Methods:
- Comprehensive literature search across multiple databases (MEDLINE, EMBASE, CENTRAL, CINAHL, domestic databases) up to December 2017.
- Inclusion of 8 RCTs (9 articles) after independent review and quality assessment.
- Meta-analysis comparing TM to usual care for asthma control and exacerbations.
Main Results:
- No statistically significant difference in pooled asthma control scores between TM and usual care (SMD 0.04, 95% CI -0.20~0.28).
- No significant difference in pooled asthma exacerbations between TM and usual care (OR 0.95, 95% CI 0.43~2.09).
- Some studies indicated TM improved patient medication and intervention adherence.
Conclusions:
- Current evidence does not show significant clinical outcome differences between TM and usual care for pediatric asthma.
- Telemonitoring may be a promising strategy for supporting self-management in pediatric asthma.
- Further high-quality research is necessary to confirm TM's impact on clinical outcomes.
Purpose:
This review aimed to evaluate the effectiveness of telemonitoring (TM) in the management of children and adolescents with asthma.
Methods:
We searched Ovid-MEDLINE, Ovid-EMBASE, CENTRAL (Cochrane Central Register of Controlled Trials), CINAHL (Cumulative Index to Nursing and Allied Health Literature), and 5 domestic databases to identify randomized controlled trials (RCTs) published through December 2017. Two reviewers independently selected relevant studies, assessed methodological quality and extracted data. We performed a meta-analysis of TM versus usual care and summarized the intervention characteristics of included studies.
Results:
Of the 3,095 articles identified, 8 RCTs (9 articles) were included in this review. The type of TM intervention of included studies was varying across studies (transmitted data, transmission frequency, data review, etc.). The pooled asthma control score was not significantly different between TM and usual care (standardized mean difference 0.04, 95% confidence interval (CI) -0.20~0.28). Another pooled analysis demonstrated no statistically significant difference in asthma exacerbation between TM and usual care (odds ratio 0.95, 95% CI 0.43~2.09). Overall, the pooled results from these studies revealed that TM did not lead to clinically significant improvements in health outcomes, but some studies in our analysis suggested that TM increased patient medication adherence and intervention adherence.
Conclusion:
The current evidence base does not demonstrate any differences between TM intervention and usual care, but TM intervention might be considered a promising strategy for the delivery of self-management support for children and adolescents with asthma. Further well-designed studies are needed to assess the effects on clinical outcomes.
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