Children with asthma using at-home monitoring app half as likely to need hospital care

Children with asthma who monitor their condition at home through the use of an app are half as likely to need hospital care as children who only receive care from healthcare teams.

New research presented at the European Respiratory Society (ERS) Congress in Amsterdam found that remote monitoring through an app reduced hospital visits among children with stable asthma symptoms and helped keep their symptoms under control.

The findings build on a previous clinical trial by the same group, which showed that remote asthma monitoring can replace up to 50 per cent of standard outpatient appointments. This new, real-world study demonstrates clear benefits of remote monitoring, which can reduce the need for hospital care among children with asthma.

The researchers say that translating the study findings into routine care settings is crucial in the digital transformation of healthcare systems.

Related Article: How can you persuade this patient to give up their salbutamol inhaler?

Childhood asthma affects around one in ten children in Europe. When it is well managed, children can lead active and healthy lives, but poorly controlled asthma leads to acute asthma exacerbations and hospitalisations.

In this study, the researchers examined data from 2,528 children with asthma, aged between six and 18, who were being treated at six Dutch hospitals between 2017 and 2023. Just over half of the children (1,374) used remote monitoring for at least part of the study period, while 2,236 children received standard care without consistent use of remote monitoring. Some of the children were included in both groups as they spent some time not using remote monitoring, then switched to remote monitoring during the study.

The group using at-home monitoring involved children and their families, who checked an app at least once a month and answered questions about lung function and asthma symptoms. The remote monitoring system, known as Luchtbrug and created by researchers from Radboud University Medical Centre, includes asthma action and treatment plans, as well as information on prescribed medications. Researchers followed the children for an average of 2-3 years and recorded the frequency of their hospitalisations, including any visits to the emergency department.

Remote monitoring was found to reduce the risk of emergency hospital visits by nearly half (49 per cent) and decrease hospital admissions by 57 per cent. The researchers estimate that one hospitalisation could be prevented for every 39 children using the app.

Overall, the proportion of children with well-controlled asthma increased from 77 per cent to 86 per cent after children and their families began using the remote monitoring app.

Dr Martinus Oppelaar from Amalia Children’s Hospital at the Radboud University Centre, who presented the research, said: ‘By studying remote monitoring in the real world, we have been able to show that there are clear benefits in terms of preventing the need for hospital care for children with asthma. We see an immediate drop in visits to the emergency room and hospitalisations, and a longer-term reduction in symptoms and children needing in-person outpatient care.’

Related Article: Quick quiz: Asthma/COPD overlap syndrome (ACOS)

He cautioned that remote monitoring will not eliminate asthma symptoms, but it can aid in managing the condition.

‘Managing a chronic disease can be tough, especially for children. Remote monitoring can make it a little bit easier and leads to better outcomes and lasting self-management skills. Crucially, the monitoring system also alerts the hospital if there are signs of children’s symptoms getting worse. This means doctors and nurses can make contact and change children’s treatment when needed,’ he added.

The researchers say the study provides strong evidence that remote monitoring can keep more children with asthma out of hospital, improving healthcare without an increase in costs.

Dr Louise Fleming, professor of practice in paediatric respiratory medicine at Imperial College London and a member of the European Respiratory Society’s expert group on paediatric asthma and allergy, commented: ‘We already have good evidence from clinical trials that at-home monitoring can keep children with asthma well. This new study builds on that research by looking at how at-home monitoring works for children and their families in normal life. The results show that with monitoring we can keep more children well and out of hospital.

Related Article: Chronic disease management: ‘Patients don’t necessarily ever need to go and see a GP’

‘If we can implement more remote services like this one, it will help us to offer the best healthcare services to our patients without increasing costs.’