image: Martinus Oppelaar
Credit: Martinus Oppelaar / ERS
Children with asthma who use at-home monitoring are around half as likely to visit the emergency department or be hospitalised, compared to those who only receive care from their medical team, according to research presented at the European Respiratory Society (ERS) Congress in Amsterdam, the Netherlands [1]. Remote monitoring also helped keep children’s symptoms under control.
At-home monitoring involved children and their families using an app approximately once a month to answer questions about asthma symptoms or track their lung function. The app also contains asthma action and treatment plans, and information on prescribed medications and instructions on how to use them. At-home monitoring is used to reduce in-person outpatient visits when children have stable asthma symptoms.
The research was presented by Dr Martinus Oppelaar from Amalia Children’s Hospital, Radboud University Center, Nijmegen, the Netherlands. He told the Congress: “Our team has previously run a successful clinical trial where we showed that remote asthma monitoring can replace 50% of standard outpatient appointments. However, routine care in the real world is more complex and messier than a highly controlled research setting.
“In the following years, we’ve been able to scale up our remote monitoring platform for large-scale use in routine care. This put us in the unique position to study how the research translates to these complex and messy routine care settings. This is a very important next step in the digital transition of health systems.”
The new research included data on 2,528 children with asthma, aged between six and 18, being cared for at six Dutch hospitals between 2017 and 2023. Of these, 1,374 children used remote monitoring at least some of the time and 2,236 children were not using remote monitoring some or all of the time. Some of the children are included in both groups as they spend some time not using remote monitoring, then switched to remote monitoring during the study.
Children were followed for two to three years on average, and, in that time, researchers recorded the number of visits children made to the hospital emergency department and whether the children were hospitalised.
The research showed that remote monitoring reduced the risk of an emergency hospital visit by around 49% and the risk of being hospitalised by around 57%. The researchers calculated that one hospitalisation could be prevented for every 39 children using remote monitoring.
The remote monitoring system Luchtbrug [2], created by researchers from Radboud University Medical Center, also collects data on whether children’s asthma symptoms are under control or not. Overall, the proportion of children with well-controlled asthma increased from 77% to 86% after they started using the system.
Dr Oppelaar 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.
“Remote monitoring is not a new drug; it won’t make your disease disappear. It can however help children and their families manage their asthma better. Managing a chronic disease can be tough, especially for children, remote monitoring can make it a little bit easier. This then 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.”
Dr Louise Fleming, from the European Respiratory Society’s expert group on paediatric asthma and allergy, and professor of practice in paediatric respiratory medicine at Imperial College London, UK, who was not involved in the research said: “Childhood asthma is extremely common, affecting around one out of every ten children in Europe. When asthma is well-controlled, children can enjoy and normal life. However, if symptoms flare up, children can become seriously ill and may need emergency treatment in hospital, and this can be horrible for children and their families.
“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.
“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.”
Method of Research
Experimental study
Subject of Research
People