eHealth in pediatric asthma care: From smart home-monitoring to implementing a new care standard

Childhood asthma is a highly prevalent episodic chronic condition that may hamper physical, social and emotional well-being. Regular follow-up of pediatric asthma is needed to prevent disease deterioration and boost quality of life. However, the current organization of pediatric asthma care, using intermittent, subjective and casual outpatient evaluation seems to conflict with the episodic nature of asthma. eHealth technology offers opportunities to monitor more objectively and when symptoms actually appear in daily life, allowing adequate and timely treatment. Literature on eHealth in pediatric asthma 1) has high heterogeneity in study endpoints and designs, 2) zeros in on specific single-parameter monitoring, while asthma is a heterogenous disease and 3) is often not specifically tailored to the pediatric population, limiting the uptake in clinical asthma guidelines. This PhD thesis therefore entails the validation, implementation and evaluation of objective home-monitoring as part of eHealth-supported pediatric asthma care.

In short this thesis highlights the high potential of objective pediatric asthma home-monitoring within the application of eHealth care. Combining home-monitoring parameters seems to improve the accurate assessment of asthma control, while identifying modifiable risk factors and personal pitfalls of asthma management. Implementation of eHealth care, combining multi-parameter home-monitoring and online communication, revealed positive impact on the efficacy and efficiency of the pediatric asthma care, warranting further steps in research and implementation. We suggest the road ahead could focus on developing temporal multi-parameter monitoring strategies, promoting uptake in medical guidelines, overcoming current implementation barriers and enable digital collaboration of healthcare professionals.