Summary of the studies included in the systematic review
| Author (Year) | Study type | Sample size (number of patients or studies) | Intervention | Key findings | Level of evidence | Biase evaluation |
|---|---|---|---|---|---|---|
| Xu et al. [34] (2010) | Randomized clinical trial | 121 patients | Interactive voice response system versus specialist nurse support versus usual care. | Lower healthcare costs in digital intervention groups, with interactive voice response being the most cost-effective. | I A | Low |
| Beerthuizen et al. [35] (2016) | Randomized clinical trial | 272 patients | Web-based asthma monitoring. | No significant differences in costs. Web-based monitoring was most cost-effective from a healthcare perspective. | I A | Moderate |
| van den Wijngaart et al. [14] (2017) | Randomized clinical trial | 210 patients | Virtual asthma clinic (VAC) versus usual care. | Asthma control and symptom-free days improved significantly more in the VAC group, reducing outpatient visits by 50%. | I A | Low |
| van den Wijngaart et al. [33] (2017) | Randomized clinical trial | 210 patients | Virtual asthma clinic versus usual care for asthma management. | Virtual visits reduced outpatient visits by 50% while maintaining asthma control. | I A | Low |
| Morton et al. [13] (2017) | Randomized clinical trial | 77 patients | Electronic adherence monitoring. | Improved adherence with reminder devices. | I A | Moderate |
| Perry et al. [30] (2017) | Randomized clinical trial | 34 patients | Smartphone-based versus paper-based asthma action plans for self-management. | Improved asthma control test scores and reported high satisfaction with smartphone. | I A | Moderate |
| Halterman et al. [17] (2018) | Randomized clinical trial | 400 patients | School-based telemedicine program versus enhanced usual care. | Telemedicine increased symptom-free days and reduced emergency visits/hospitalizations. | I A | Moderate |
| Perry et al. [18] (2018) | Randomized clinical trial | 393 patients | School-based asthma education via telemedicine versus usual care. | Increased use of peak flow meters and improved medication adherence. | I A | Moderate |
| Belisario et al. [41] (2013) | Systematic review (Cochrane review) | 2 studies | Smartphone and tablet-based asthma self-management apps versus traditional paper-based methods. | Findings were inconclusive; one study showed no impact on symptoms or healthcare use, while another reported improved quality of life, lung function, and fewer emergency visits. | I A | High |
| Vazquez-Ortiz et al. [43] (2020) | Systematic review | 108 studies | Analysis of challenges faced by adolescents and young adults with asthma and allergic conditions. | The review identified five key challenges: quality of life impairment, psychological factors, adherence issues, self-management facilitators, and supportive relationships. Most studies focused on asthma, with limited data on other allergic conditions. | I A | Moderate |
| Knibb et al. [40] (2020) | Systematic review | 30 studies | Psychological, e-health, educational, peer-led, and breathing retraining interventions for asthma self-management. | All interventions improved self-management, quality of life, and adherence, but most were feasibility or pilot studies. No studies included allergic conditions beyond asthma. | I A | Moderate |
| Kim et al. [6] (2020) | Systematic review | 7 studies | School-based interventions. | Benefits of school-based telemedicine. | I A | Moderate |
| Culmer et al. [31] (2020) | Systematic review | 5 studies | Telemedical asthma education for school-age children. | Telemedicine-based asthma education showed mixed results but improved caregiver quality of life and self-management. | I B | Moderate |
| Snoswell et al. [36] (2021) | Systematic review and meta-analysis | 16 studies | Interactive telehealth interventions for asthma management. | Telehealth interventions slightly improved quality of life, with web portals being the most effective, followed by smartphone apps and remote monitoring. | I A | Low |
| Shah & Badawy [15] (2021) | Systematic review | 11 studies | Telemedicine in pediatric asthma. | Benefits in adherence and symptom control. | I A | Low |
| Jochmann et al. [46] (2017) | Observational study | 93 patients | Electronic monitoring of inhaled corticosteroids (Smartinhaler) to assess adherence. | Electronic monitoring identified four patient groups by adherence and asthma control. 58% showed suboptimal adherence. | III C | High |
| Khaleva et al. [44] (2020) | Observational study | 1,179 patients | Survey on current transition management for adolescents and young adults with allergy and asthma. | Most healthcare professionals reported lacking transition guidelines and structured processes. Nearly half noted poor communication between pediatric and adult services. | III C | High |
| Jácome et al. [39] (2021) | Observational study | 107 patients | InspirerMundi app for monitoring asthma medication adherence through gamification, symptom tracking, and social support. | The app was feasible and well-accepted for monitoring medication adherence. | III C | High |
| Haynes et al. [47] (2022) | Observational study | 502 patients | Assessment of telemedicine use for pediatric asthma care. | Families valued better access but reported challenges with measurements and scheduling. | III C | Moderate |
| Radhakrishnan et al. [32] (2022) | Observational study | 100 patients | Comparison of in-person versus virtual asthma education. | Virtual and in-person asthma education were equally effective, with 65.2% preferring virtual education for its safety, convenience, and accessibility. | III C | High |
