Remote Monitoring Is Associated With Less Routine and Emergency Care in Pediatric Asthma

There is need for real-life, long-term and large-scale multicentre studies on remote monitoring (RM) in respiratory care to determine its true potential for daily practice. We aimed to analyze the effect of RM with digital action plans on healthcare utilization in long-term pediatric asthma care.

This was a cohort study in six Dutch pediatric asthma clinics from 2017 until 2023 using healthcare utilization and RM data. Children aged 6-18 years with ≥ 2 years follow-up were included. Differences in median number of outpatient visits between the RM and regular care groups were assessed. Incidence rate ratios (IRR) were calculated for emergency visits and hospitalizations. Interrupted time series analysis was used to evaluate changes in number of outpatient visits after introduction of RM over time. Asthma control of children with RM was analyzed over time.

We included 2526 children, of which 1372 (54.2%) used RM. The median number of annual outpatient visits was lower in the RM group than in the regular care group (ΔMedian 0.65, p < 0.001). RM was associated with a decreased risk of emergency visits (IRR 0.52; 95% CI 0.44, 0.61) and hospitalizations (IRR 0.43; 95% CI 0.34, 0.55). RM was associated with an annual outpatient visit reduction of -9.4 (95% CI -17.0, -1.9) per 100 children. The proportion of children with controlled asthma increased from 76.7% to 86.0% 3 years after introduction of RM.

RM with digital treatment plans is associated with reductions in both regular and emergency healthcare utilization while maintaining high rates of well-controlled asthma.