Abstract

Background:
Asthma remains one of the most prevalent chronic conditions in children and adolescents worldwide, significantly impacting quality of life, school attendance, and healthcare utilization. Conventional management often struggles with adherence, access barriers, and inconsistent monitoring. Telemedicine, leveraging digital platforms such as mobile apps, video consultations, SMS reminders, and web-based education, offers a promising approach to improve asthma outcomes in young populations.

Objective:
This systematic review and meta-analysis evaluated the effectiveness of telemedicine interventions in improving asthma control, quality of life (QoL), and healthcare utilization among children and adolescents compared to standard in-person care.

Methods:
Following PRISMA 2020 guidelines, PubMed and CENTRAL databases were searched (2012–2024). Eligible studies were randomized controlled trials (RCTs) enrolling children aged 3–18 years, comparing telemedicine with standard care, and reporting on symptom-free days (SFDs), Asthma Control Test/Questionnaire (ACT/ACQ) scores, QoL, or emergency department (ED) visits. Seven RCTs (n = 2,139) met inclusion criteria. Pooled analyses used random-effects models, with mean differences (MD) or odds ratios (OR) and 95% confidence intervals (CI).

Results:
Telemedicine interventions demonstrated significant benefits across all primary outcomes. Symptom-free days improved by nearly half a day per two weeks (MD = 0.48, 95% CI 0.20–0.76, p = 0.0006). Asthma control was enhanced (MD = –0.18, 95% CI –0.28 to –0.09, p = 0.0002), reflecting better ACT/ACQ scores. QoL scores showed modest but meaningful gains (MD = 0.14, 95% CI 0.02–0.26, p = 0.02). Importantly, telemedicine reduced the odds of ED visits by 29% (OR = 0.71, 95% CI 0.55–0.92, p = 0.009). Heterogeneity was low to moderate across outcomes.

Conclusion:
This meta-analysis provides high-quality evidence that telemedicine significantly improves asthma control, increases symptom-free days, enhances quality of life, and reduces ED visits in children and adolescents. Findings support telemedicine as an effective adjunct to conventional care, particularly in resource-limited or geographically remote settings. Future research should standardize intervention protocols, assess long-term outcomes, and address equity in digital health access.