OBJECTIVES: Telemedicine is increasingly used to improve health outcomes in asthma. However, the knowledge of each type of telemedicine effect on health outcome is still lacked. This study aims to determine the effect of each type of telemedicine on asthma control and quality of life in adults with asthma.

METHODS: An electronic search was performed from the inception to January 2017 on the following databases: Cochrane CENTRAL, CINAHL, ClinicalTrials.gov, EMBASE, PubMed and Scopus. Randomized controlled trials that assessed the effect of telemedicine on adults with asthma were included. Levels of asthma control and quality of life were the outcomes of interest. A random-effects model meta-analysis was performed.

RESULTS: A total of 17 studies (9,274 subjects) was included in this systematic review. Nine studies investigated single-telemedicine (Tele-case management, Tele-consultation, Tele-education, Tele-monitoring, and Tele-reminder). Eight studies investigated combined-telemedicine (Combined Tele-case management, Combined Tele-consultation, and Combined Tele-case management & Tele-consultation). Meta-analyses suggested that Combined Tele-case management could significantly improve asthma control compared with usual care [Standardized mean difference (SMD)=0.78 (95% CI: 0.56-1.01)], followed by Combined Tele-case management & Tele-consultation [SMD=0.52 (95% CI: 0.13-0.91)], and Combined Tele-consultation [SMD=0.35 (95% CI: 0.03-0.68)] estimated by changes in asthma symptom scores (asthma control questionnaire, asthma control test, short questionnaire and the perceived control of asthma questionnaire). In addition, Combined Tele-case management was the most effective telemedicine for improving quality of life. The second and third best telemedicine were Combined Tele-consultation, and Tele-case management estimated by changes in asthma quality of life questionnaire scores (Jupiter asthma quality of life questionnaire and Jupiter mini asthma quality of life questionnaire).

CONCLUSIONS: Combined Tele-case management and Combined Tele-consultation appeared to be good telemedicine for improving asthma control and quality of life in adults with asthma. Our findings could be an evidence supported for healthcare professionals to implement effective telemedicine interventions for adult asthmatic patients.