Impact of Telemedicine on Asthma Control and Quality of Life in Children and Adolescents: A Systematic Review and Meta-Analysis.

Abstract

<h4>Background</h4>Asthma is the most common chronic respiratory disease in children and adolescents, associated with high morbidity and healthcare costs. Telemedicine has emerged as a strategy to improve access to care, adherence to treatment and symptom control. However, its effectiveness in the pediatric population has not been clearly studied.<h4>Objective</h4>To assess the clinical effectiveness of telemedicine interventions in asthma control and health-related quality of life in asthmatic children and adolescents.<h4>Methodology</h4>A systematic review and meta-analysis were performed following PRISMA-2020 guidelines, with previous registration in PROSPERO (CRD42025251000837). Sixteen randomized clinical trials (n = 2642) with patients aged 2-18 years were included. The interventions included videoconferencing, mobile applications, web systems, interactive voice response and mobile units in schools. The outcomes were measured using validated quality-of-life (PAQLQ) and asthma control (ACT/c-ACT) questionnaires.<h4>Results</h4>Seven studies were incorporated into the PAQLQ meta-analysis, whose overall effect was non-significant (mean difference = 0.06; 95% CI: -0.06 to 0.18; I² = 5.7%). Five studies provided ACT/c-ACT data, showing a significant effect in favor of telemedicine (mean difference = 0.61; 95% CI: 0.32 to 0.90; I² = 73%). Complementary qualitative analysis revealed improvements in adherence, reduction in exacerbations, emergency department visits and use of rescue medication.<h4>Conclusions</h4>Telemedicine improves the clinical control of pediatric asthma, although its impact on the quality of life is limited. Multicenter trials with long-term follow-up and cost-effectiveness evaluation are required.