Table 1.
Descriptions of the 21 studies included in the meta-analysis
| Study | No. of participants; country; setting | Intervention studied | Main outcomes |
|---|---|---|---|
| Barbanel et al.20 | 24 adults with asthma; UK; socioeconomically deprived setting in London | Telephone | Score on the North of England Asthma Symptoms Scale at baseline and after 3 mo |
| Bynum et al.21 | 36 adolescents with asthma; US; socioeconomically deprived setting in rural Arkansas | Video conferencing | Checklist of the patient’s technique for using a metered dose inhaler and patient’s level of satisfaction with the technology |
| Chan et al.22 | 120 children with asthma; US; army medical center pediatric clinic in Honolulu, Hawaii | Video conferencing | Adherence to treatment (e.g., patient’s use of inhaled corticosteroids), diary of disease control (e.g., use of rescue therapy), patient’s quality-of-life scores, number of visits to the emergency department, number of admissions to hospital, patient’s technique when using an inhaler |
| Chatkin et al.23 | 271 people with asthma aged ≥ 12 yr; Brazil; Porto Alegre | Telephone | Adherence to treatment measured according to number of doses from a dry-powder disk inhaler |
| Clark et al.24 | 808 adult women with asthma; US; University of Michigan Health System | Telephone | Symptoms (e.g., days and nights of work or study missed due to asthma), number of visits to the emergency department, number of admissions to hospital, number of unscheduled urgent visits to clinics, number of scheduled visits to clinics, questions related to patient’s sex (e.g., relationship between symptoms and menstrual cycle, use of contraceptive medications), patient’s quality of life, self confidence in managing asthma |
| Cruz-Correia et al.25 | 21 adults with asthma; Portugal; Porto | Internet | Patient opinions of technologies, time taken to fill in diaries, adherence to monitoring tools |
| de Jongste et al.26 | 150 children with asthma aged 6–18 yr ; Italy and the Netherlands; hospital care or academic centres in Padua, Italy, and Rotterdam, the Netherlands | Other networked system | Expired nitric oxide before and after treatment with salbutamol at 3, 12, 21 and 30 w; carer’s quality of life; adverse events |
| Donald et al.27,28 | 71 adults with asthma aged 18–55 yr; Australia; hospital in Victoria, Australia | Telephone | Admissions to hospital, ownership of peak expiratory flow meter, a plan for management of care, use of the health care system, days lost from work or study, exacerbations requiring the use of oral corticosteroids |
| Gruffydd-Jones et al.29 | 194 patients with asthma aged 17–70 yr; UK; family practice | Telephone | Responses to a six-question questionnaire on asthma control (symptoms), asthma- specific quality of life, exacerbations, economic evaluation from the perspective of the health service |
| Guendelman et al.30 | 134 children with asthma aged 8–16 yr; US; primary care facility in California | Other networked system | Symptoms including coughing and wheezing, number of days of school missed due to asthma, peak expiratory flow rate, use of the health care system (number of visits to the emergency department or admissions to hospital) |
| Jan et al.31 | 164 children with asthma aged 6–12 yr; Taiwan; university medical centre | Other networked system | Peak expiratory flow rate (recorded in asthma diaries, morning and night), symptoms (Childhood Asthma Control Test at baseline and after 12 w), patient’s quality of life, caregiver’s knowledge |
| Khan et al.32 | 310 children; Australia; patients had been discharged from a hospital emergency department in Sydney | Telephone | Symptoms (number of days patient had a wheeze in the last 3 mo), possession and use of a written action plan for asthma, use of preventive medication, patient’s knowledge of asthma, parental quality of life, number of visits to family physician or specialist |
| Kokubu et al.33 | 53 adults with asthma; Japan; patients who had visited the emergency department due to asthma more than twice in the last year | Other networked system | Number of visits to emergency department, ability to perform activities of daily living, adherence to testing lung function and transmission of data |
| Kokubu et al.34 | 75 adults with asthma; Japan; multicentre trial involving 17 medical institutions (patients were selected if they had visited the night emergency department three or more times in one year despite treatment with oral corticosteroids) | Other networked system | Number of admissions to hospital, adherence to measurement of peak expiratory flow and to medications, quality of life, economic effectiveness of telehealthcare intervention |
| Ostojic et al.35 | 16 patients with asthma; Croatia; a respiratory clinic | Text messaging | Tests of pulmonary function; patients’ daily records of peak expiratory flow rate, symptoms and variability; use of asthma medication; cost and reliability of text messaging (validated against patient diaries) |
| Pinnock et al.36,37 | 278 adults with asthma; UK; all had requested a prescription for a bronchodilator inhaler in the last 6 mo, and none had received a review of their asthma in a general practice in the last 11 mo | Telephone | Proportions of patients reviewed in each arm of study within three months of randomization, length of consultation, asthma morbidity, quality of life, patient satisfaction with the review consultation, costs of respiratory care from the perspective of the health service, cost of the review service, cost per consultation |
| Pinnock et al.38 | 1809 adults with asthma; UK; single large general practice spread across three sites | Telephone | Proportion of patients who had an asthma review; asthma morbidity; impact of consultation on patient’s ability to self-manage asthma; adverse events; time, cost and mode of review |
| Rasmussen et al.39 | 300 people with asthma; Denmark; recruited directly from the community in Copenhagen | Internet | Patient’s quality of life, self-care for asthma, smoking, level of education, salary, days taken as sick leave and number of admissions to hospital, severity of symptoms, current use of medication, lung function at baseline and 6 mo later, responsiveness of airways after dose of methacholine |
| van der Meer et al.40 | 200 adults with asthma aged 18–50 yr; the Netherlands; Leiden | Choice of text messaging or Internet | Responses to a 12-item questionnaire on consumer knowledge of asthma, patient’s technique using an inhaler, number of changes in medications per patient, number of visits to a physician, number of contacts by telephone and Web communication, asthma-related quality of life, symptoms (e.g., responses to the Asthma Control Questionnaire, number of days free of symptoms) |
| Vollmer et al.41 | 6948 adults; US; patients were listed on a health insurer’s registry as having asthma or had been given antiasthma medication for at least 180 d in Portland, Oregon | Telephone | Responses to surveys mailed by the insurer to a random sample of 549 members of a health plan for indicative results (83% rate of response), use of the health care system, use of medication (e.g., frequency), patient’s quality of life |
| Willems et al.42,43,44 | 56 children with asthma aged ≥ 7 yr and 53 adults with asthma; the Netherlands; a hospital in Maastricht | Other networked system | Spirometry data, clinical symptoms (scored in patient diaries), patient’s quality of life, use of the health care system, self-reported use of medication |
Note: UK = United Kingdom, US = United States.