Abstract
BackgroundInadequate pediatric asthma care has resulted in potentially avoidable unplanned hospital admissions and morbidity. A wide variety of digital technologies have been developed to monitor and support treatment adherence in children and adolescents with asthma. However, existing reviews need to be updated and expanded to provide an overview of the current state of research on these technologies and how they are being integrated into existing health care services and care pathways.ObjectiveThis study aims to provide an overview of the current research landscape and knowledge gaps regarding the use of digital technologies to support the care of children and adolescents with asthma.MethodsThis study was structured according to the PRISMA-ScR (Preferred Reporting Items for Systematic Reviews and Meta-Analyses extension for Scoping Reviews) and Population, Intervention, Comparator, Outcome, and Study frameworks. Five databases (PubMed, the Cochrane Central Register of Controlled Trials, Web of Science, Embase, and PsycINFO) were systematically searched for studies published in English from 2014 onward. Two reviewers independently screened the references and selected studies for inclusion based on the eligibility criteria. Data were systematically extracted per research question, which were synthesized in a descriptive analysis.ResultsA wide variety of study characteristics, including the number and age of participants, study duration, and type of digital intervention, were identified. There was mixed evidence for the effectiveness of the interventions. Of the 10 studies that evaluated treatment adherence, 7 (70%) found improvements, but the evidence was inconsistent for asthma control (6/9, 67% of studies reported improvement or maintenance, but only 1 was significantly different between groups) and health outcome variables (5/9, 56% of studies found no evidence of effectiveness). The 6 studies that examined patient perceptions and assessments of acceptability and usability generally had positive findings.ConclusionsA wide range of digital interventions are being developed and evaluated to support the monitoring and treatment adherence of children and adolescents with asthma. Meta-analyses are inhibited by the use of samples with a variety of overlapping age ranges; a theoretical framework for evaluating specific age groups would aid comparison between studies. Most studies found significant evidence for improved adherence to treatment or medications, but there was mixed evidence of the impact of the digital interventions on asthma control and other health outcomes. There are gaps in the literature relating to cost-effectiveness and integration with existing clinical care pathways. This study will be necessary to determine which digital interventions for children and young people with asthma are worth supporting and adopting in the clinical care pathways.
Highlights
BackgroundGlobally, asthma is the most common chronic illness affecting children [1,2,3] and can have serious health consequences
The search was performed in five databases (PubMed, the Cochrane Central Register of Controlled Trials (CENTRAL), Web of Science, EMBASE, and PsycINFO) using the University of Plymouth’s search tool Primo, with slightly adjusted search terms to fit the specific structure of each database
Summary of Findings There was a lot of variety in the studies examined in this review; study duration ranged from 3 weeks to 2 years, the number of participants ranged from 22 of 1187, and - the review was focused on children and adolescents - there was a wide range of ages studied, with no distinct age groups emerging from the studies
Summary
BackgroundGlobally, asthma is the most common chronic illness affecting children [1,2,3] and can have serious health consequences. A wide variety of digital technologies have been developed to help monitor and support treatment adherence for children and adolescents with asthma. Objective: The purpose of this scoping review is to provide an overview of the current research landscape and knowledge gaps regarding the use of digital technologies to support the care of children and adolescents with asthma. There was mixed evidence for the effectiveness of the interventions; 7 of the 10 studies that evaluated treatment adherence found improvements, but the evidence was inconsistent for asthma control (6/9 reported improvement or maintenance, but only one was significantly different between groups) and health outcome variables (5/9 found no evidence of effectiveness). Conclusions: A wide range of different digital interventions are being developed and evaluated to support the monitoring and treatment adherence of children and adolescents with asthma. There are gaps in the literature relating to cost-effectiveness and integration with existing clinical care pathways; this research will be necessary to determine which digital interventions for children and young people with asthma are worth supporting and adopting in the clinical care pathways
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