Background: Inadequate paediatric asthma care has resulted in potentially avoidable unplanned hospital admissions and morbidity. A wide variety of digital technologies have been developed to help monitor and support treatment adherence for children and adolescents with asthma. However, existing reviews need to be updated and expanded to provide an overview of the current state of research around these technologies and how they are being integrated into existing healthcare services and care pathways.
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.
Methods: The review was structured according to the Preferred Reporting Items for Systematic Reviews and Meta-Analyses extension for Scoping Reviews (PRISMA-ScR) and Population, Intervention, Comparator, Outcome, and Study (PICOS) frameworks. Five databases (PubMed, the Cochrane Central Register of Controlled Trials (CENTRAL), Web of Science, EMBASE, and PsycINFO) were systematically searched for studies published in English from 2014 on. Two reviewers independently screened the references and selected studies for inclusion based on the eligibility criteria. Data was systematically extracted per research questions, which were synthesised in a descriptive analysis.
Results: A wide variety in study characteristics - including the number and age of participants, study duration, and type of digital intervention - was identified. 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). The 6 studies that examined patient perceptions and assessments of acceptability and usability had generally positive findings.
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. 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 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.