Accepted for/Published in: Journal of Medical Internet Research
Date Submitted: Feb 24, 2024
Date Accepted: Sep 30, 2024
Effectiveness and acceptability of asynchronous digital health in asthma care: a mixed-methods systematic review
ABSTRACT
Background:
Asynchronous digital health (e.g., online portal, text, email communication) can overcome practical barriers associated with in-person and remote synchronous (real-time) consultations. However, little is known about the effectiveness and acceptability of asynchronous digital health to support care for individuals with asthma (e.g. asthma reviews).
Objective:
We aimed to systematically review the qualitative and quantitative evidence on the role of asynchronous digital health for asthma care.
Methods:
Following Cochrane methodology, we searched six databases (January 2001 – July 2022; search update: September 2023) for quantitative/qualitative/mixed-methods studies on supporting routine asthma care using asynchronous digital health. Screening and data extraction were duplicated. We conducted a meta-analysis of trial data and a thematic analysis of qualitative data. PROSPERO registration number: CRD42022344224.
Results:
We included 30 studies (20 quantitative, 6 qualitative, 4 mixed-methods). Asynchronous digital consultations linked with other functionalities, compared to usual care, improved asthma control (SMD 0.32; 95% CI 0.02 to 0.62; P=.04) and reduced hospitalisations (RR 0.36; 95% CI 0.14 to 0.94; P=.04). However, there were no significant differences in quality of life (SMD 0.16; 95% CI -0.12 to 0.43; P=.26). or emergency department visits (RR 0.83; 95% CI 0.33 to 2.09; P=.69). Patients appreciated the convenience of asynchronous digital health, though healthcare professionals expressed concerns. Successful implementation necessitates an organisational approach. Integrative synthesis underscored the ease of asking questions, monitoring logs, and medication reminders as key digital functionalities.
Conclusions:
Asynchronous consultation supported by digital functionalities is an effective and convenient option for non-emergency asthma care.
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