Asthma

Remote delivery of supported self‐management for asthma “effective, acceptable, and safe”


Remote consultations could form a central pillar of the delivery framework for routine annual asthma review, after an analysis showed benefits such as increased patient engagement and attendance.

The research, published in the journal Health Expectations,  found use of remote consultations to be “an acceptable, effective and safe alternative to face-to-face consultations” for providing patients with information and guidance on self-management of their condition.

“Across a broad range of contexts, remote consultations are highly accepted by both patients and professionals, and are as clinically effective and safe as face-to-face reviews to provide self-management support,” said the authors from the Asthma UK Centre for Applied Research.

Their review included 18 papers published between 2003 and 2020, undertaken in the UK (n = 10), the US and Canada (n = 7) and Italy (n = 1), 11 of which had the primary goal of assessing the use of remote consultations in routine asthma reviews.

The researchers extracted relevant data from these papers using Context‐Mechanism‐Outcome (C‐M‐O) configurations, and then synthesised it into overarching themes based on the PRISMS taxonomy of supported self‐management.

This led to the identification of six key themes which the authors said describe how supported self‐management can be delivered during remote asthma consultations: increased regulatory attendance and patients monitoring; opportunities to provide individualised information; provision of convenient/flexible access to advice and support; enhanced healthcare professional-patient relationships and communication; appropriate provision of specific practical asthma self‐management strategies (self-inhaler technique); and increased patient confidence and self‐efficacy.

The benefits linked with remote asthma care, including improved convenience, access and attendance, largely overrode key challenges and patients concerns over the quality of such interactions, the authors said.

Overall, their findings showed that “for many patients and healthcare professionals, remote consultations are more highly accepted than in‐person consultations, and were equally as effective and safe as face‐to‐face reviews.”

Looking forward, future research should look at how telecommunication can be implemented “in ways that are most valued by patients and clinicians, to fit within the organisational and technical infrastructure of healthcare services and embrace the culture of delivering supported self‐management”.

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