Asthma Management in the Digital Age

Overview

Journal Front Allergy

Specialty Allergy & Immunology

Date 2024 Sep 18

PMID 39291253

Authors

Ilan Y Bocian

Andrew R Chin

Alyssa Rodriguez

William Collins

Sayantani B Sindher

R Sharon Chinthrajah

Affiliations

Soon will be listed here.

Abstract

Asthma affects 25 million people in the United States, and its prevalence is increasing. Access to care and adherence to prescribed asthma-treatment programs remain the principal formidable challenges for asthma management. Telemedicine offers substantial opportunities for improved asthma care of patients across the full range of socioeconomic strata. Ever-improving digital tools for asthma assessment and treatment are key components of telemedicine platforms for asthma management. These include a variety of remote patient-monitoring devices, digital inhaler systems, and mobile-health applications that facilitate ongoing assessment and adherence to treatment protocols. Digital tools for monitoring treatment focus on tracking medication use, inhalation technique, and physiological markers such as peak-flow rate and pulse-oximetry. Telemedicine visits allow for elements of assessment via video, approximating or duplicating many aspects of in-person visits, such as evaluating a patient's general appearance, breathing effort, and cough. Challenges remain in ensuring equitable access to these technologies, especially in rural and low-income areas, and in maintaining patient privacy and data security in digital platforms.

References

Mosnaim G, Stempel D, Gonzalez C, Adams B, BenIsrael-Olive N, Gondalia R . The Impact of Patient Self-Monitoring Via Electronic Medication Monitor and Mobile App Plus Remote Clinician Feedback on Adherence to Inhaled Corticosteroids: A Randomized Controlled Trial. J Allergy Clin Immunol Pract. 2020; 9(4):1586-1594. DOI: 10.1016/j.jaip.2020.10.064. View

Shaker M, Oppenheimer J, Grayson M, Stukus D, Hartog N, Hsieh E . COVID-19: Pandemic Contingency Planning for the Allergy and Immunology Clinic. J Allergy Clin Immunol Pract. 2020; 8(5):1477-1488.e5. PMC: 7195089. DOI: 10.1016/j.jaip.2020.03.012. View

Portnoy J, Pandya A, Waller M, Elliott T . Telemedicine and emerging technologies for health care in allergy/immunology. J Allergy Clin Immunol. 2020; 145(2):445-454. DOI: 10.1016/j.jaci.2019.12.903. View

Bajowala S, Shih J, Varshney P, Elliott T . The Future of Telehealth for Allergic Disease. J Allergy Clin Immunol Pract. 2022; 10(10):2514-2523. PMC: 9420069. DOI: 10.1016/j.jaip.2022.08.022. View

Ferrante G, Licari A, Marseglia G, La Grutta S . Digital health interventions in children with asthma. Clin Exp Allergy. 2020; 51(2):212-220. PMC: 7753570. DOI: 10.1111/cea.13793. View

Cabrerizo-Carreno H, Munoz-Esquerre M, Santos Perez S, Romero-Ortiz A, Fabrellas N, Guix-Comellas E . Impact of the implementation of a telemedicine program on patients diagnosed with asthma. BMC Pulm Med. 2024; 24(1):32. PMC: 10787462. DOI: 10.1186/s12890-024-02843-y. View

Rand C, Wise R . Measuring adherence to asthma medication regimens. Am J Respir Crit Care Med. 1994; 149(2 Pt 2):S69-76; discussion S77-8. DOI: 10.1164/ajrccm/149.2_Pt_2.S69. View

Hirosawa T, Harada Y, Ikenoya K, Kakimoto S, Aizawa Y, Shimizu T . The Utility of Real-Time Remote Auscultation Using a Bluetooth-Connected Electronic Stethoscope: Open-Label Randomized Controlled Pilot Trial. JMIR Mhealth Uhealth. 2021; 9(7):e23109. PMC: 8367161. DOI: 10.2196/23109. View

Myrick K, Mahar M, DeFrances C . Telemedicine Use Among Physicians by Physician Specialty: United States, 2021. NCHS Data Brief. 2024; (493):1-8. View

10.

Waibel K . Synchronous telehealth for outpatient allergy consultations: A 2-year regional experience. Ann Allergy Asthma Immunol. 2016; 116(6):571-575.e1. DOI: 10.1016/j.anai.2016.03.028. View

11.

Dunbar-Jacob J, Erlen J, Schlenk E, Ryan C, Sereika S, Doswell W . Adherence in chronic disease. Annu Rev Nurs Res. 2000; 18:48-90. View

12.

Graves J, Abshire D, Amiri S, Mackelprang J . Disparities in Technology and Broadband Internet Access Across Rurality: Implications for Health and Education. Fam Community Health. 2021; 44(4):257-265. PMC: 8373718. DOI: 10.1097/FCH.0000000000000306. View

13.

Ramos Hernandez C, Nunez Fernandez M, Pallares Sanmartin A, Roibas C, Cerdeira Dominguez L, Botana Rial M . Validation of the portable Air-Smart Spirometer. PLoS One. 2018; 13(2):e0192789. PMC: 5825056. DOI: 10.1371/journal.pone.0192789. View

14.

Price D, Roman-Rodriguez M, McQueen R, Bosnic-Anticevich S, Carter V, Gruffydd-Jones K . Inhaler Errors in the CRITIKAL Study: Type, Frequency, and Association with Asthma Outcomes. J Allergy Clin Immunol Pract. 2017; 5(4):1071-1081.e9. DOI: 10.1016/j.jaip.2017.01.004. View

15.

Doenges J, Kuckuck E, Cassel W, Hildebrandt O, Weissflog A, Sohrabi K . Disease control in patients with asthma and respiratory symptoms (wheezing, cough) during sleep. Asthma Res Pract. 2020; 6:9. PMC: 7513478. DOI: 10.1186/s40733-020-00062-w. View

16.

Rojahn K, Laplante S, Sloand J, Main C, Ibrahim A, Wild J . Remote Monitoring of Chronic Diseases: A Landscape Assessment of Policies in Four European Countries. PLoS One. 2016; 11(5):e0155738. PMC: 4873167. DOI: 10.1371/journal.pone.0155738. View

17.

van den Wijngaart L, Roukema J, Boehmer A, Brouwer M, Hugen C, Niers L . A virtual asthma clinic for children: fewer routine outpatient visits, same asthma control. Eur Respir J. 2017; 50(4). DOI: 10.1183/13993003.00471-2017. View

18.

Yao P, Adam M, Clark S, Hsu H, Stern M, Sharma R . A scoping review of the unassisted physical exam conducted over synchronous audio-video telemedicine. Syst Rev. 2022; 11(1):219. PMC: 9559902. DOI: 10.1186/s13643-022-02085-1. View

19.

Richardson C, Orr N, Ollosson S, Irving S, Balfour-Lynn I, Carr S . Initiating home spirometry for children during the COVID-19 pandemic - A practical guide. Paediatr Respir Rev. 2021; 42:43-48. PMC: 7893248. DOI: 10.1016/j.prrv.2021.02.001. View

20.

Barr R, Stemple K, Mesia-Vela S, Basner R, Derk S, Henneberger P . Reproducibility and validity of a handheld spirometer. Respir Care. 2008; 53(4):433-41. PMC: 3595551. View