Culmer Nathan, Smith Todd, Stager Catanya, Wright Andrea, Burgess Karen, Johns Samantha, Watt Mykaela, Desch Madison
College of Community Health Sciences, The University of Alabama, Tuscaloosa, Ala.
College of Community Health Sciences, The University of Alabama, Tuscaloosa, Ala.
J Allergy Clin Immunol Pract. 2020 Jun;8(6):1908-1918. doi: 10.1016/j.jaip.2020.02.005. Epub 2020 Feb 19.
Telemedicine in a school-based setting involving partnerships between a child with asthma and health care provider can provide patients and caregivers with opportunities to better manage chronic conditions, communicate among partners, and collaborate for solutions in convenient locations.
This systematic review examined outcomes for school-age children with asthma involving asthma-based telemedical education.
Guided by the Preferred Reporting Items for Systematic Reviews and Meta-Analyses, we searched 4 databases with terms related to asthma, education, and pediatrics. Included articles involved a school-based setting, children and adolescents, a telemedical mechanism for training, empirical study designs, and peer review. We extracted data regarding (a) participant background, (b) research methods and purpose, and (c) outcomes.
A total of 408 articles were identified. Five met inclusion criteria. Three studies were randomized and 2 were cohort studies. In addition to clinical and educational outcomes, studies reported on satisfaction, self-management, asthma knowledge gain, and quality of life (QOL). We found support for caregiver/parent QOL and participant self-management behaviors. We also found mixed results for participant QOL. Clinical outcomes showed mixed support regarding airway inflammation improvement, medication use improvement, improvements in symptom burden and symptom-free days, and spirometry improvements.
Results of real-time telemedically delivered asthma education to improve QOL, enhance symptom management ability, and reduce symptom burden were positive or nonsignificant. No study indicated negative effects due to telemedicine. Limited results indicate that patient education can, under certain circumstances, positively influence asthma burden. Further validation of intervention methods and tools as well as outcome measurement consistency is recommended.
在学校环境中开展的远程医疗，涉及哮喘患儿与医疗服务提供者之间的合作关系，可为患者及其照护者提供机会，以便在便利的地点更好地管理慢性病、在合作伙伴之间进行沟通并共同协作寻求解决方案。
本系统评价考察了基于哮喘远程医学教育的学龄期哮喘儿童的治疗效果。
以系统评价和Meta分析的首选报告项目为指导，我们使用与哮喘、教育和儿科学相关的术语检索了4个数据库。纳入的文章涉及学校环境、儿童和青少年、远程医学培训机制、实证研究设计以及同行评审。我们提取了有关以下方面的数据：（a）参与者背景；（b）研究方法和目的；（c）治疗效果。
共识别出408篇文章。5篇符合纳入标准。3项研究为随机对照试验，2项为队列研究。除了临床和教育效果外，研究还报告了满意度、自我管理、哮喘知识掌握情况以及生活质量（QOL）。我们发现照护者/父母的生活质量和参与者的自我管理行为得到了支持。我们还发现参与者生活质量的结果不一。临床效果在气道炎症改善、药物使用改善、症状负担和无症状天数的改善以及肺功能检查改善方面的支持情况不一。
实时远程医学哮喘教育在改善生活质量、提高症状管理能力和减轻症状负担方面的结果为阳性或无显著差异。没有研究表明远程医学会产生负面影响。有限的结果表明，在某些情况下，患者教育可以对哮喘负担产生积极影响。建议进一步验证干预方法和工具以及结果测量的一致性。
