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Exploring Perspectives and Barriers in Implementing Home Monitoring for Pediatric Pulmonary Diseases: Mixed Methods
Mees Hp Stoop1,2, Romy Krul1, Badies Han Manai3
1Department of Pediatrics, Haga Teaching Hospital, Juliana Children's Hospital, The Hague, South Holland, The Netherlands.
Background:
Home monitoring has the potential to enable early detection of disease progression in pediatric lung diseases such as asthma and cystic fibrosis (CF). There is minimal evidence regarding the opinions of caregivers and children on home monitoring.
Objective:
This study aimed to explore children's and caregivers' perspectives on home monitoring.
Methods:
This multicenter, mixed methods study included children aged 6 to 18 years with asthma or CF and their caregivers. Participants were recruited from Juliana Children's Hospital and Erasmus MC Sophia Children's Hospital between September 2023 and June 2025. Participants completed a structured questionnaire assessing experiences, attitudes, and potential barriers and facilitators to home monitoring. Fourteen children and their caregivers took part in in-depth interviews. Conventional content analysis was applied to both open-text and interview data.
Results:
A total of 113 caregiver-child dyads (62 [54.9%] asthma and 51 [45.1%] CF) participated in this study. Willingness to use home monitoring was high among both children (asthma: n=47, 83.9%; CF: n=30, 62.5%) and caregivers (asthma: n=54, 87.1%; CF: n=44, 86.3%). Children with asthma and their caregivers showed significantly greater willingness to use the proposed types of home monitoring than children with CF and their caregivers. Caregivers who expressed difficulty with symptom interpretation were significantly more motivated to use home monitoring. Key barriers included time demands, usability, device size, and concerns about maintaining personal contact with health care providers. Facilitators included compact, user-friendly devices, clear instructions, and improved disease understanding.
Conclusions:
High willingness to adopt home monitoring was observed among children with asthma and children with CF, but preferences and perceived barriers differ. Tailoring device choice and implementation strategies to patient needs, minimizing burden, and integrating medical oversight are important for successful uptake.
