Towards improved asthma control in children by non-invasive home monitoring

Uncontrolled asthma in children impairs quality of life, emphasizing the need for effective symptom monitoring. Traditional follow-up visits may miss episodes of poor asthma control. This study aimed to evaluate if digital home monitoring including non-invasive vital parameter measurements via a smartwatch, medical feedback, and coaching can detect early signs of disease deterioration and improve asthma control. In this twelve-week prospective single-arm intervention study, 40 children with asthma (ages 6-18) were monitored at home using an app, smartwatch, and spirometer. Continuous vital parameters, monthly (Childhood) Asthma Control Test ((C)-ACT) scores, and weekly home lung function measurements were collected. Medical feedback was provided based on specific cut-off values. Changes in asthma control were analyzed using multivariable logistic regression. An increase in nocturnal heart rate was significantly associated with worsening (C)-ACT scores (OR: 2.11, CI: 1.068-4.168, p = 0.032), even after adjusting for Salbutamol use. Although C-ACT scores showed a trend towards improvement (baseline: 22.5, study end: 24, p = 0.063), no significant change in lung function was observed. Additionally, a higher frequency of lung function testing was linked to worsening (C)-ACT scores. Increased nocturnal heart rate was significantly associated with deteriorating (C)-ACT scores. These findings suggest that non-invasive home monitoring has potential in managing paediatric asthma.