Study: Telehealth may have role in severe asthma improvements

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Telehealthcare interventions are unlikely to result in clinically relevant improvements in health outcomes in those with relatively mild asthma, but they may have a role in those with more severe disease who are at high risk of hospital admission, according an October study published in the Cochrane Library.

“Healthcare systems internationally need to consider new models of care to cater for the increasing numbers of people with asthma,” wrote Susannah McLean, of the Allergy & Respiratory Research Group, Centre for Population Health Sciences, University of Edinburgh in Edinburgh, U.K., and colleagues. “Telehealthcare interventions are increasingly being seen by policymakers as a potential means of delivering asthma care.”

Defining telehealthcare as healthcare delivered from a distance, facilitated electronically and involving the exchange of information through the personalized interaction between a healthcare professional using their skills and judgment and the patient providing information, the authors undertook a literature review to assess the effectiveness of telehealthcare interventions in people with asthma.

Two review authors independently appraised studies for inclusion, extracted data and performed meta-analyses while the researchers analyzed dichotomous variables to produce an odds ratio and continuous variables to construct a mean difference.

The 21 studies were included to investigate a range of technologies aiming to support the provision of care from a distance. These included: telephone (nine); video-conferencing (two); internet (two); other networked communications (six); text messaging (one) or a combination of text and Internet (one).

“Meta-analysis showed that these interventions did not result in clinically important improvements in asthma quality of life,” the researchers found. Telehealth for asthma resulted in a non-significant increase in the odds of emergency department visits over a 12-month period.

There was, however, a significant reduction in hospitalizations over a 12-month period; the effect being most marked in people with more severe asthma managed predominantly in secondary care settings, according to the researchers.

“The potential benefits of telehealthcare include greater accessibility for patients, reduced time and cost expenditure associated with travelling, earlier detection of disease exacerbations and associated reduced risk of hospital admissions for asthma,” McLean and colleagues stated. “These interventions are, however, not without risk and it is therefore important to study the effectiveness of such telehealthcare initiatives rigorously.”

Further trials evaluating the effectiveness and cost-effectiveness of a range of telehealthcare interventions are needed,” the researchers concluded.