Remote digital asthma management shows modest quality of life and lung function improvements in adults

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Frontiers in Medicine Published April 2, 2026 Medically reviewed May 26, 2026 Study authors: Shan Tian, Xiaonan Huang, Jian Li, Caitao Chen, Hong Zhang DOI ↗ By Dr. Amelia Tan, PhD · Internal Medicine & Chronic Disease

Key Takeaway

Consider remote digital asthma tools as adjuncts; quality of life gains were modest and below MCID.

This systematic review and meta-analysis pooled data from 10 randomized controlled trials involving adults with physician-diagnosed asthma. The analysis compared interactive remote digital management—using smartphone applications or web-based platforms—against usual care, with follow-up of at least 6 months. The primary outcome was quality of life measured by the Mini Asthma Quality of Life Questionnaire (mini-AQLQ).

At 6 months, mini-AQLQ scores improved by a mean difference (MD) of 0.47 (95% CI 0.02 to 0.92), and at 12 months by MD 0.35 (95% CI 0.21 to 0.49). Secondary outcomes also showed improvement: the Asthma Control Questionnaire (ACQ) improved by MD -0.37 (95% CI -0.62 to -0.13) at 12 months, and FEV1% predicted increased by MD 4.49% (95% CI 1.11 to 7.87). All results were statistically significant.

Safety and tolerability data were not reported in the meta-analysis. The GRADE assessment rated evidence certainty as high for FEV1% predicted, moderate for 12-month mini-AQLQ, and very low for ACQ and 6-month mini-AQLQ due to risk of bias and inconsistency. A key limitation is that the quality of life improvements did not reach the established minimal clinically important difference (MCID) of 0.5. The findings support structured, clinician-supported digital interventions as a useful, though limited, adjunct to standard pharmacologic management for adult asthma.

Study Details

Study typeMeta analysis

EvidenceLevel 1

PublishedMar 2026

View Original Abstract ↓

Remote, digitally delivered asthma management is increasingly used in routine care, but its long-term impact on core clinical outcomes in adults remains uncertain. We conducted a systematic review and meta-analysis of randomized controlled trials evaluating interactive remote digital management (smartphone applications or web-based platforms) vs. usual care in adults with physician-diagnosed asthma and ≥6 months follow-up. Primary outcome was Mini Asthma Quality of Life Questionnaire (mini-AQLQ) at 6 and 12 months. Secondary outcomes included Asthma Control Questionnaire (ACQ) at 12 months, FEV1% predicted at 12 months. Random-effects models generated pooled mean differences (MD) or risk ratios. Ten trials were included. Remote digital interventions improved mini-AQLQ at 6 months (MD 0.47, 95% CI 0.02 to 0.92) and 12 months (MD 0.35, 95% CI: 0.21 to 0.49) and ACQ at 12 months (MD −0.37, 95% CI: −0.62 to 0.13). FEV1% predicted increased at 12 months (MD 4.49%, 95% CI: 1.11 to 7.87). Subgroup analyses suggested more consistent benefits for web-based programs than for app-based interventions. GRADE rated evidence as high for FEV1% predicted, moderate for 12-month mini-AQLQ, and very low for ACQ and 6-month mini-AQLQ due to risk of bias and inconsistency. Interactive remote digital management statistically significant but modest improvements in quality of life and symptom control, which did not reach the established MCID of 0.5. These findings support structured, clinician-supported digital interventions as a useful, though limited, adjunct to standard pharmacologic management for adult asthma. https://www.crd.york.ac.uk/PROSPERO/view/CRD420251133851, identifier: CRD420251133851.