Remote Monitoring Reduces Pediatric Asthma Hospitalizations by 58% in Dutch Multicentre Study
Key Insights
A multicentre Dutch study of 1,278 children with asthma demonstrated that remote monitoring significantly reduced emergency visits by 45% and hospitalizations by 58% compared to standard care.
Asthma control improved dramatically from 68.6% at baseline to 90.1% after 43 months of remote monitoring implementation across four hospitals.
Children using remote monitoring required fewer outpatient visits with a median reduction of 0.62 visits per year, while maintaining high patient satisfaction ratings.
Remote monitoring technology has demonstrated significant potential to transform pediatric asthma care, with new research showing substantial reductions in hospital visits and improved disease control among children. A comprehensive multicentre study presented at ERS Congress 2025 revealed that remote monitoring in routine pediatric asthma care significantly reduced hospital visits and improved asthma control compared with standard care approaches.
Major Reductions in Healthcare Utilization
The Dutch study analyzed healthcare data from 1,278 children with asthma across four hospitals between 2017-2023, with more than half of participants (53.8%) using remote monitoring for at least part of the follow-up period. Children aged 6-18 years were tracked for at least 2 years, allowing researchers to compare outpatient, emergency, and hospital visits between groups.
The results demonstrated striking improvements in healthcare utilization. Emergency visits were reduced by 45% in the remote monitoring group (incidence rate ratio [IRR]: 0.55; 95% CI: 0.44-0.68), with a number needed to treat of 24. Even more impressive, hospitalizations were cut by 58% (IRR: 0.42; 95% CI: 0.30-0.59), with a number needed to treat of 35.
Children using remote monitoring also required fewer outpatient visits, with a median reduction of 0.62 visits per year (p<0.001). Interrupted time series analysis confirmed a significant ongoing reduction in outpatient visits over time.
Dramatic Improvement in Disease Control
Beyond reducing healthcare visits, remote monitoring showed remarkable impact on asthma control itself. The study found that asthma control improved from 68.6% at baseline to 90.1% after 43 months of remote monitoring implementation.
Implementation Challenges and Patient Experience
A separate pilot study published in Annals of Allergy, Asthma & Immunology provided insights into the practical implementation of remote therapeutic monitoring in underserved populations. The study assessed 20 children aged 5 to 17 years (mean age, 8.8 years; 60% boys; 75% Hispanic/Latino; 35% Spanish speakers) with high-risk asthma receiving care at an urban mobile clinic.
The pilot study achieved high engagement rates, with researchers reaching 20 of 24 eligible children (83% recruitment rate) and maintaining 95% retention over the 6-month study period. Patient satisfaction was notably high, with an average rating of 4.6 out of 5 among the 14 patients who completed satisfaction surveys.
Technical and Access Barriers
Despite the positive outcomes, implementation faced several challenges. The most common issue was discovery of inhaled corticosteroid (ICS) discontinuation or loss of insurance coverage at the pharmacy when refilling medication, affecting 8 patients. Supply chain issues led to a 4-month wait time for sensors in 3 cases.
Data transmission presented additional complications, with discrepancies between medication use and sensor detection reported in seven patients. "Among three participants, the clinician portal indicated that children had used their inhaler several times in a short period, but when the clinical team followed up, the parent and child reported that the data in the digital platform had recorded uses of their medication that the patients said had not occurred," the researchers noted.
Conversely, four participants appeared to have low ICS adherence according to sensor data, yet parents and children reported taking their medication as prescribed while observing that actuations were not being recorded.
Clinical Outcomes and Adherence
Among patients with more than 12 weeks of sensor use, the average ICS adherence rate was 51.8%. The pilot study documented improvements in several asthma-related outcomes, including an increase in short-acting beta-agonist (SABA)-free days per month from 23 days in month 1 to 26 days in month 6. Asthma-related emergency department visits were reduced from 10 visits in the 6 months before intervention to 5 visits during the 6-month intervention period.
Provider Perspectives and Future Directions
Healthcare providers expressed mixed experiences with remote monitoring implementation. While recognizing the potential benefits, providers identified challenges with RTM not consistently meeting patient needs and integration difficulties with existing workflows. "Providers felt that additional support for patients and staff would improve feasibility," the researchers noted.
Despite implementation challenges, more than two-thirds of patients (71%) expressed interest in continued use of remote therapeutic monitoring, suggesting strong patient acceptance of the technology.
The research builds real-world evidence for integrating digital health strategies into routine pediatric respiratory care. As one research team noted, "Patients and families find [remote therapeutic monitoring] useful, but they face barriers accessing both medication and technology, such as pharmacy refill issues and supply chain limitations. Once patients receive and sync their devices, they remain engaged and find the reminders useful."