Systematic Review of Digital Interventions for Pediatric Asthma Management

Ramsey, Rachelle R.; Plevinsky, Jill M.; Kollin, Sophie R.; Gibler, Robert C.; Guilbert, Theresa W.; Hommel, Kevin A.

doi:10.1016/j.jaip.2019.12.013

Cited by 83 publications

(82 citation statements)

References 57 publications

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“…56 In children and young people, a systematic review (15 studies) found personalised text messaging was the most commonly used digital intervention for asthma care and that nearly all of the included interventions significantly improved adherence; most also improved health outcomes. 57 In contrast, another systematic review found mixed results for telemedicine in school-aged children, with no evidence of harm, but some studies found no effect and others found improvements in health outcomes and adherence. 58 A 2018 review found eHealth tools may be particularly useful for self-monitoring in children and adolescents with asthma.…”

Section: Remote Carementioning

confidence: 99%

Asthma and COVID-19: review of evidence on risks and management considerations

Hartmann‐Boyce

Gunnell

Drake

et al. 2020

BMJ EBM

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BackgroundRespiratory illnesses typically present increased risks to people with asthma (PWA). However, data on the risks of COVID-19 to PWA have presented contradictory findings, with implications for asthma management.ObjectiveTo assess the risks and management considerations of COVID-19 in people with asthma (PWA).MethodWe conducted a rapid literature review. We searched PubMed, medRxiv, LitCovid, TRIP, Google and Google Scholar for terms relating to asthma and COVID-19, and for systematic reviews related to specific management questions within our review, in April 2020. References were screened and data were extracted by one reviewer.ResultsWe extracted data from 139 references. The evidence available is limited, with some sources suggesting an under-representation of PWA in hospitalised cases and others showing an increased risk of worse outcomes in PWA, which may be associated with disease severity. Consensus broadly holds that asthma medications should be continued as usual. Almost all aspects of asthma care will be disrupted during the pandemic due not only to limits in face-to-face care but also to the fact that many of the diagnostic tools used in asthma are considered aerosol-generating procedures. Self-management and remote interventions may be of benefit for asthma care during this time but have not been tested in this context.ConclusionsEvidence on COVID-19 and asthma is limited and continuing to emerge. More research is needed on the possible associations between asthma and COVID-19 infection and severity, as well as on interventions to support asthma care in light of constraints and disruptions to healthcare systems. We found no evidence regarding health inequalities, and this urgently needs to be addressed in the literature as the burdens of asthma and of COVID-19 are not equally distributed across the population.

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Section: Remote Carementioning

confidence: 99%

Asthma and COVID-19: review of evidence on risks and management considerations

Hartmann‐Boyce

Gunnell

Drake

et al. 2020

BMJ EBM

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“…78 Overall, future research in this field should be based on larger and rigorous controlled trials with objective adherence assessment and post-intervention evaluation of long-term efficacy. 42 Finally, unique regulatory concerns need to be addressed with the increasing use of these new technologies. Not all devices require approval by regulatory bodies or need an evidence-based background to be marketed.…”

Section: Future D Irec Ti On S and Con Clus Ionmentioning

confidence: 99%

“…In the intentionto-treat analysis, ICS adherence was 25.4% higher in the intervention group than in the usual care group (24-month mean adherence:44.5% vs 35.5%, respectively; P < .001), suggesting the potential for such a digital intervention in children with persistent asthma 41. Text messages: personalized text messaging include automated messages (ie standardized messages sent at the same time every day regardless of whether medication had already been taken), or text messages delivered in response to missed doses 42. Personalized text message reminders were used in a 6-month longitudinal cross-over study in 64 adolescents with poorly controlled asthma.…”

mentioning

confidence: 99%

Digital health interventions in children with asthma

Ferrante

Licari

Grutta

2020

Clin Experimental Allergy

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Although healthcare providers are actively involved in offering education, information and interventions for asthmatic patients, medication and therapeutic adherence remain low in the paediatric population, with estimates suggesting that adherence rates hover below 50%. A range of available digital health interventions has been explored in paediatric asthma with promising but variable results, limiting their widespread adoption in clinical practice. They include emerging technologies that yield the advantage of tracking asthma symptoms and medications, setting drug reminders, improving inhaler technique and delivering asthma education, such as serious games (video games designed for medical‐ or health‐related purposes), electronic monitoring devices, speech recognition calls, text messaging, mobile apps and interactive websites. Some of the proposed digital interventions have used multiple components, including educational and behavioural strategies and interactions with medical professionals. Overall, the implementation of such interventions may offer the opportunity to improve adherence and asthma control. In a state of emergency as the COVID‐19 pandemic, telemedicine can also play a central role in supporting physicians in managing children with asthma. This review evaluates the published literature examining digital health interventions for paediatric asthma and explores the most relevant issues affecting their implementation in practice and the associated evidence gaps, research limitations and future research perspectives.

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“…Despite these technological advances, few eHealth studies have been conducted in childhood asthma care (12), and the widespread application of eHealth is far from our daily clinical practice. However, eHealth studies show promising results (13) and could disrupt care for several reasons: home monitoring measurements, which are acquired when symptoms actually occur at home, can provide potentially more information compared to time-based scheduled visits when healthcare professionals have to rely on patient/parent report and recall.…”

Section: Novel Approaches To Childhood Asthma Care Supported By Ehealthmentioning

confidence: 99%

COVID-19: Technology-Supported Remote Assessment of Pediatric Asthma at Home

et al. 2020

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The COVID-19 crisis has pressured hospital-based care for children with high-risk asthma as they have become deprived of regular clinical evaluations. However, COVID-19 also provided important lessons about implementing novel directions for care. Personalized eHealth technology, tailored to the individual and the healthcare system, could substitute elements of hospital care and facilitate early and appropriate medical anticipation in response to imminent loss of control. This perspective article discusses new approaches to the clinical, organizational, and scientific aspects of the use of eHealth technology in pediatric asthma care in times of COVID-19, as illustrated by a case report of an acute asthma exacerbation possibly caused by COVID-19 infection.

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Systematic Review of Digital Interventions for Pediatric Asthma Management

Cited by 83 publications

References 57 publications

Asthma and COVID-19: review of evidence on risks and management considerations

Asthma and COVID-19: review of evidence on risks and management considerations

Digital health interventions in children with asthma

COVID-19: Technology-Supported Remote Assessment of Pediatric Asthma at Home

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