In rural areas, access to asthma specialists is often a challenge for families who have children with asthma. A new study indicates that telemedicine can be a viable alternative to traditional in-person physician-based care for the treatment and management of children’s asthma conditions.
Researchers at Kansas City, Mo.-based Children’s Mercy Hospital conducted a study to compare asthma outcomes during a six-month period in children managed by telemedicine versus in-person visits. The study was published in the Annals of Allergy, Asthma and Immunology, a scientific publication of the American College of Allergy, Asthma and Immunology (ACAAI).
“Allergists are the best-trained medical specialists to treat asthma, but not everyone lives close to an allergist. Children who live hundreds of miles from the nearest allergist may not be receiving the best and most cost-effective care,” according to an ACAAI press release about the study.
In the study, patients who scheduled an appointment to be seen for asthma in the allergy clinic at Children's Mercy Hospital (CMH) in Kansas City, and who lived long distances from the hospital, were identified. They were offered a choice of keeping their original in-person appointment, or changing it to a telemedicine visit. The telemedicine option involved a visit to a local clinic. The control group of patients was seen at the allergy clinic at CMH. The two groups were followed over six months.
The telemedicine process involved real-time use of a Remote Presence Solution (RPS) equipped with a digital stethoscope for listening to heart and lungs, a digital otoscope for examining ears and nose, and a high-resolution camera. A telefacilitator operated the RPS and performed diagnostic and educational procedures, such as spirometry and asthma education. The telemedicine sessions required a registered nurse or respiratory therapist at the site to operate the telemedicine equipment. This allowed the allergist to see and hear the patient in real-time, and to pan and zoom a wide-angle camera.
Children in both groups were assessed initially, after 30 days, and at six months.
Asthma outcome measures included asthma control using validated tools (Asthma Control Test, Childhood Asthma Control Test, and Test for Respiratory and Asthma Control in Kids) and patient satisfaction (telemedicine group only), according to the study authors.
During the study, of 169 children, 100 were seen in-person and 69 via telemedicine. A total of 34 in-person and 40 telemedicine patients completed all three visits.
“All of those seen—whether in the clinic or by telemedicine—showed an improvement in asthma control over the six months,” allergist Chitra Dinakar, M.D., one of the study authors, said in a statement. “We were encouraged because sometimes those with the greatest need for an asthma specialist live in underserved areas such as rural or inner-city communities where allergists aren't always available. The study shows these kids can get effective care from a specialist, even if they don't happen to live close to where an allergist practices.”
Allergist Jay Portnoy, M.D., lead authors of the study, concluded, “We found that children seen by telemedicine using real-time video conferencing and digital exam equipment was just as effective as in-person visits. In addition, there were high levels of satisfaction by the kids and their parents, regarding the long-distance care.”
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