A virtual asthma clinic for children: fewer routine outpatient visits, same asthma control

Eur Respir J. 2017 Oct 5;50(4):1700471. doi: 10.1183/13993003.00471-2017. Print 2017 Oct.

Abstract

eHealth is an appealing medium to improve healthcare and its value (in addition to standard care) has been assessed in previous studies. We aimed to assess whether an eHealth intervention could improve asthma control while reducing 50% of routine outpatient visits.In a multicentre, randomised controlled trial with a 16-month follow-up, asthmatic children (6-16 years) treated in eight Dutch hospitals were randomised to usual care (4-monthly outpatient visits) and online care using a virtual asthma clinic (VAC) (8-monthly outpatient visits with monthly web-based monitoring). Outcome measures were the number of symptom-free days in the last 4 weeks of the study, asthma control, forced expiratory volume in 1 s, exhaled nitric oxide fraction, asthma exacerbations, unscheduled outpatient visits, hospital admissions, daily dose of inhaled corticosteroids and courses of systemic corticosteroids.We included 210 children. After follow-up, symptom-free days differed statistically between the usual care and VAC groups (difference of 1.23 days, 95% CI 0.42-2.04; p=0.003) in favour of the VAC. In terms of asthma control, the Childhood Asthma Control Test improved more in the VAC group (difference of 1.17 points, 95% CI 0.09-2.25; p=0.03). No differences were found for other outcome measures.Routine outpatient visits can partly be replaced by monitoring asthmatic children via eHealth.

Publication types

  • Randomized Controlled Trial

MeSH terms

  • Administration, Inhalation
  • Adrenal Cortex Hormones / therapeutic use*
  • Ambulatory Care / statistics & numerical data
  • Anti-Asthmatic Agents / therapeutic use*
  • Asthma* / diagnosis
  • Asthma* / therapy
  • Child
  • Disease Progression
  • Female
  • Humans
  • Male
  • Netherlands
  • Outcome Assessment, Health Care
  • Outpatients / statistics & numerical data
  • Patient Care Management / methods
  • Quality Improvement
  • Remote Consultation / methods*
  • Respiratory Function Tests
  • Telemedicine / methods
  • Telemetry / methods*

Substances

  • Adrenal Cortex Hormones
  • Anti-Asthmatic Agents

Associated data

  • NTR/NTR 2689