COVID-Forced Telemedicine Boosts Asthma Visit Show Rates in Inner City Kids

By Megan Brooks

November 23, 2020

NEW YORK (Reuters Health) - During the COVID-19 pandemic, telemedicine has helped asthmatic children living in Los Angeles maintain control of their disease and actually increased asthma visit "show" rates, according to a new study.

"With the disruption of the pandemic and school closures, there was a concern that children with asthma who normally receive care at local school sites would not continue to engage in regular, preventative care and thus, have worsening asthma control," Dr. Lyne Scott, director of the Los Angeles Breathmobile Program, told Reuters Health by email.

"The takeaway and long-term implications of this study are that telehealth is a valuable option when face-to-face visits are not available," said Dr. Scott, associate professor of pediatrics at the Keck School of Medicine of USC.

Dr. Kenny Kwong, also at USC, presented the study November 13 during the American College of Allergy, Asthma and Immunology (ACAAI) virtual annual meeting.

When COVID-19 hit, face to face visits for asthmatic children participating in the Breathmobile program were cancelled and converted to telemedicine visits. This "experiment in nature" allowed evaluation of telephone visits in maintaining asthma control in these patients, the researchers note in their meeting abstract.

Patients regularly followed by the Breathmobile were contacted by their care provider at the time of their originally scheduled face-to-face visit.

Over four months (starting March 16), the researchers tracked patient engagement in telemedicine by following show rates - how often parents brought their kids to an appointment rather than being a no-show.

"We found that not only did kids show up for appointments, but their show rates were also significantly higher than during the same period in 2019," Dr. Kwong said in a news release.

In addition, during the telemedicine period, over 90% of patients maintaining good asthma control, with asthma-control test (ACT) scores and the percentage of patients in control not statistically different from the same time in 2019.

Provider and nursing staff from the Breathmobile reported a 32% to 62% increase in the amount of time spent with each patient during telemedicine visits compared to in-person visits.

"Kids with asthma need treatment that is consistent and specialized to their individual needs," Dr. Scott said in the news release. "It's reassuring and encouraging that the quality of care young patients, including those in underserved populations, received via virtual access kept their asthma under control. This study shows it's possible to move towards new models of treatment that increase access and convenience for the patient, and still maintain quality of care."

Dr. Scott told Reuters Health, "There are some limitations to telehealth in terms of evaluation of lung function and asthma related co-morbidities such as skin testing for allergic triggers, so face-to-face visits are still needed."

SOURCE: American College of Allergy, Asthma and Immunology (ACAAI) Annual Scientific Meeting, presented November 13, 2020.