The Effects of Telemedicine on Asthma Control and Patients’ Quality of Life In Adults: A Systematic Review and Meta-Analysis

Publication date: Available online 25 July 2018

Source: The Journal of Allergy and Clinical Immunology: In Practice

Author(s): Bunchai Chongmelaxme, Shaun Wen Huey Lee, Teerapon Dhippayom, Surasak Saokaew, Nathorn Chaiyakunapruk, Piyameth Dilokthornsakul

Abstract

Background

Telemedicine is increasingly used to improve health outcomes in asthma. However, it is still inconclusive which telemedicine works effectively.

Objective

This study aimed to determine the effects of telemedicine on asthma control and the quality of life in adults.

Methods

An electronic search was performed from the inception to March 2018 on the following databases: Cochrane CENTRAL, CINAHL, ClinicalTrials.gov, EMBASE, PubMed and Scopus. Randomized controlled trials that assessed the effects of telemedicine in adults with asthma were included in this analysis, and the outcomes of interest were levels of asthma control and quality of life. Random-effects model meta-analyses were performed.

Results

A total of 22 studies (10,281 participants) was included. Each of eleven studies investigated the effects of single-telemedicine, and combined-telemedicine (combinations of telemedicine approaches), and the meta-analyses showed that combined tele-case management could significantly improve asthma control compared with usual care [standardized mean difference (SMD) = 0.78 (95% CI: 0.56, 1.01)]. Combined tele-case management & tele-consultation [SMD = 0.52 (95% CI: 0.13, 0.91)], and combined tele-consultation [SMD = 0.28 (95% CI: 0.13, 0.44)] also significantly improved asthma outcomes, but to a lesser degree. In addition, combined tele-case management [SMD = 0.59 (95% CI: 0.31, 0.88)] was the most effective telemedicine for improving quality of life, followed by combined tele-case management & tele-consultation [SMD = 0.31 (95% CI: 0.03, 0.59)], tele-case management [SMD = 0.30 (95% CI: 0.05, 0.55)], and combined tele-consultation [SMD = 0.27 (95% CI: 0.11, 0.43)], respectively.

Conclusions

Combined-telemedicine involving tele-case management or tele-consultation appear to be effective telemedicine interventions to improve asthma control and quality of life in adults. Our findings are expected to provide healthcare professionals with current evidence of the effects of telemedicine on asthma control and patients' quality of life.