Recommendations for clinical practice of telemedicine in pediatric and adolescent asthmatic patients
| Recommendation category | Recommendation description | Level of evidence and strength |
|---|---|---|
| Recommendation Grade A (“is recommended”) | ||
| Telemedicine for control and follow-up | The use of telemedicine is recommended for pulmonary function testing, medication, and symptom tracking, as well as for control and quality of life questionnaires in the management and follow-up of pediatric and adolescent asthma patients. | I A moderate |
| Quality of life in patients with severe asthma | The use of telemedicine is recommended to improve the quality of life of pediatric and adolescent asthma patients, especially those with severe asthma. | I A moderate |
| Cost-effectiveness of telemedicine | It is recommended to evaluate the cost-effectiveness of the various tools encompassed by telemedicine separately. | I A moderate |
| It is recommended to analyze the cost-effectiveness of telemedicine for the follow-up of pediatric and adolescent asthma patients and as a complement to conventional visits. | I A moderate | |
| Recommendation Grade B (“may be recommended”) | ||
| Mixed approach | The mixed approach, alternating telemedicine with in-person visits, may be recommended for the appropriate management of asthma in pediatric and adolescent patients. | I B moderate |
| Adolescent patient with asthma | Telemedicine may be recommended as an essential tool in the management of asthma in adolescent patients. | I B moderate |
| Telemedicine may be recommended to overcome barriers of distance and accessibility and to provide a personalized approach that improves the quality of life of adolescent patients with asthma. | IV B moderate | |
| Difficult-to-control asthma | Telemedicine may be recommended for patients with difficult-to-control asthma to assess treatment adherence, adjust it, and evaluate the need for in-person visits. | II B strong |
| Research | The need for further studies may be recommended to evaluate optimal strategies that ensure satisfaction for patients, their families, and all healthcare professionals. | II B moderate |
| Recommendation Grade C (“could be recommended”) | ||
| Home-based monitoring | The recording of various parameters could be recommended for asthma management from home to enable the early detection of exacerbations. | III C moderate |
| Quality of care | Telemedicine could be recommended to improve the quality of care for pediatric and adolescent patients with asthma. | III C moderate |
| It could be recommended that telemedicine consultations be scheduled only for patients who do not require a physical examination. | III C moderate | |
| Benefits of telemedicine | Telemedicine could be recommended for its beneficial effects on asthma management and control, as well as for the high level of acceptance and satisfaction reported by patients. | III C moderate |
| Digital interventions | Digital interventions that include educational strategies, behavioral approaches, and interactions with medical professionals could be recommended to improve adherence and asthma control. | IV C moderate |
| Recommendation Grade D (“may be considered”) | ||
| Ethical aspects | Ethical issues, privacy, and information security may be considered major concerns and limitations of telemedicine. | V D moderate |
| Technology | The familiarization of patients and their families with the use of mobile phones, tablets, computers, and network applications may be considered essential for the implementation of a telemedicine program. | V D weak |
| Technological solutions can only be considered opportunities for success if combined with the medical team to achieve maximum benefit. | V D weak | |
