The New Era of Telemedicine Brings Positive Health Outcomes for Patients With Asthma

Telemedicine is defined as the use of technology to enhance patient health outcomes by increasing access to medical information and treatment. A recent meta-analysis shows that combined telemedicine involving telecase management or teleconsultation has significant improvements in asthma control and quality of life.

Improvements in technology have brought the increased use of telemedicine. Follow-ups, consultations, and even diagnosis can now be done through a telephone or video chat instead of a visit to the doctor’s office. The use of telemedicine may be increasing, but the benefits of it compared to usual care is unknown. Researchers sought to determine health outcomes of telemedicine in patients with asthma through a meta-analysis of 22 studies on asthma control and quality of life.

Telemedicine is classified into 5 categories: telecase management, teleconsultation, tele-education, telemonitoring, and telereminder. Interventions sorted into telecase management and other telemedicine, but not teleconsultation were defined as combined telecase management, while interventions sorted into telecase consultation and other telemedicine, but not telecase management were defined as teleconsultation. If teleconsultation, telecase management, and other telemedicine were all included, the classification was defined as combined telecase management and teleconsultation.

Of the 22 studies, 13 of them reviewed the effects of telemedicine on asthma control. Using the Asthma Control Questionnaire, along with other score tools, the studies found that no single telemedicine intervention caused a significant improvement in asthma control. However, combined telecase management (P < .001), combined telecase management and teleconsultation (P = .009), and combined teleconsultation (P < .001) all provided significant improvements in asthma control. Fourteen of the 22 studies also examined the effect of telemedicine on quality of life through mainly the Mini Asthma Quality of Life Questionnaire. From these studies, the only single telemedicine that showed a significant improvement in the quality of life of patients with asthma was telecase management (P = .018). Furthermore, combined telecase management (P < .001), combined teleconsultation (P = .001), and combined telecase management and teleconsultation (P = .028), all showed some significant evidence of improving quality of life.

Other outcome assessments were also reviewed in many of these studies used for the meta-analysis. In 1 study, telecase management and teleconsultation reduced total corticosteroid use without lowering asthma control or quality of life. Another found that pharmacists using telemonitoring improved asthma control compared with usual care (P < .001). One other interesting finding found telecase management and telephone text-based tele-education to have no significant differences in promoting adherence (P = .10), according to another study.

The analysis of multiple studies on the impact of telemedicine on patients with asthma showed that combined telemedicine was the most effective telemedicine method in improving patient care, the researchers wrote. The use of different approaches seems to synergize with each other and create a greater effect for the patient, as evidenced by the improved asthma control and quality of life. Although the results cannot be generalizable to other chronic diseases, these findings help at least provide the starting evidence that telemedicine is effective.

Reference

Chongmelaxme B, Lee S, Dhippayom T, Saokaew S, Chaiyakunapruk N, Piyameth D. The effects of telemedicine on asthma control and patients’ quality of life in adults: a systemic review and meta-analysis. J Allergy Clin Immunol Pract. 2018; pii: S2213-2198(18)30450-1. doi: 10.1016/j.jaip.2018.07.015.