Home Monitoring May Help Asthma Control in Pediatric Patients

Recent research findings published in Scientific Reports demonstrate benefits of home monitoring pediatric patients with asthma. Specifically, benefits were observed when medical feedback was integrated throughout the study’s duration, particularly when supporting patient reassurance, engagement, and awareness in uncertain situations.¹

Asthma is a chronic lung disease that impacts the patient’s airways. In children, asthma is the leading cause of chronic illness, affecting about 7.5 million US children, according to Cleveland Clinic. Concerningly, the rate of pediatric asthma is steadily increasing, with exposure to allergens (e.g., dust, secondhand smoke, toxins) and weakened immune systems because of lack of exposure to childhood illness and genetics being possible factors. Although children with asthma do not all have the same symptoms, the most common include frequent coughing spells, less energy during play, rapid breathing or shortness of breath, and tightness or pain in the chest.²

Diagnosing asthma in children—particularly under the age of 6 years—is often difficult because the condition can have similar symptoms to other illnesses. Additionally, younger children usually cannot perform pulmonary function tests that can diagnose asthma. Because diagnosis and treatment are more difficult in children than in adults, support and asthma control are crucial to enhance their quality of life.²

The aim of this study was to evaluate the effects of real-time digital home monitoring using (childhood) asthma control test, home lung function measurements with medical feedback, on asthma control and coaching. Additionally, potential correlations between vital parameters assessed by wearables and the Children-Asthma Control Test ([C]-ACT) scores were assessed, hypothesizing that deviations in these parameters—such as increased nocturnal heart rate or reduced spirometry values—will be associated with changes in (C)-ACT scores, indicating either improvement or deterioration in asthma control.¹

The prospective, single-arm, intervention study enrolled children aged 6 to 18 years with asthma who were digitally monitored at home for a 12-week duration via an online health care platform, home spirometry, and wearables. Oral and written informed consent were obtained from the parents or legal guardians, and children aged 12 and over also provided their consent, according to the investigators.¹

The primary end point was assessed using the Dutch validated web-based version of the C-ACT for young children or the ACT for older children, with scores of 19 or lower being indicative of poorly controlled or uncontrolled asthma. Secondary end points include the wearables’ collected heart rate and physical activities—which were gathered every minute and retrieved once every 24 hours—and FEV1, which was measured in accordance with American Thoracic Society/European Respiratory Society standards.¹

Forty patients with a median age of 9 years were enrolled in the study. Thirty-eight were included in the final analysis, as 2 were lost to follow-up due to not attending the exclusion visit after 12 weeks. Most of the patients were male (68.4%), were phadiatop-positive (84.2%), were using inhaled corticosteroids (ICS; 92.1%), and were not indirectly exposed to smoking (84.2%).¹

The investigators observed an increase in nocturnal heart rate which was significantly associated with worsening (C)-ACT scores (OR: 2.11 [95% CI: 1.068–4.168]; p = .032), even after adjusting for salbutamol use. Although C-ACT scores desmontrated a trend toward improvement (baseline: 22.5, study end: 24.0; p = .063), no significant change in lung function was shown. 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, according to the investigators, suggest that noninvasive home monitoring has potential in managing pediatric asthma.¹

“This study highlights the benefits of home monitoring with medical feedback. While home spirometry did not consistently correlate with asthma severity, it proved useful in other ways. Supporting patient reassurance, engagement, and awareness, particularly in uncertain situations. Its value may therefore lie more in behavioral support than in direct clinical decision-making,” concluded the authors. “Despite associations between noninvasive measures and asthma control, challenges with long-term adherence emphasize the need for strategies to maintain engagement. Future research should involve larger cohorts and longer monitoring periods to validate these findings.”¹

REFERENCES

1. Gijsen CEW, Lucas J, Muris JWM, van Horck MWP, Sieben AEP, Dompeling E. Towards improved asthma control in children by non-invasive home monitoring. Sci Rep 15, 39423 (2025). doi:10.1038/s41598-025-22921-3

2. Cleveland Clinic. Childhood asthma. Accessed November 13, 2025. https://my.clevelandclinic.org/health/diseases/6776-asthma-in-children