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Papadopoulos NG, Custovic A, Deschildre A, Gern JE, Nieto Garcia A, Miligkos M, Phipatanakul W, Wong G, Xepapadaki P, Agache I, Arasi S, Awad El-Sayed Z, Bacharier LB, Bonini M, Braido F, Caimmi D, Castro-Rodriguez JA, Chen Z, Clausen M, Craig T, Diamant Z, Ducharme FM, Ebisawa M, Eigenmann P, Feleszko W, Fierro V, Fiocchi A, Garcia-Marcos L, Goh A, Gómez RM, Gotua M, Hamelmann E, Hedlin G, Hossny EM, Ispayeva Z, Jackson DJ, Jartti T, Jeseňák M, Kalayci O, Kaplan A, Konradsen JR, Kuna P, Lau S, Le Souef P, Lemanske RF, Levin M, Makela MJ, Mathioudakis AG, Mazulov O, Morais-Almeida M, Murray C, Nagaraju K, Novak Z, Pawankar R, Pijnenburg MW, Pite H, Pitrez PM, Pohunek P, Price D, Priftanji A, Ramiconi V, Rivero Yeverino D, Roberts G, Sheikh A, Shen KL, Szepfalusi Z, Tsiligianni I, Turkalj M, Turner S, Umanets T, Valiulis A, Vijveberg S, Wang JY, Winders T, Yon DK, Yusuf OM, Zar HJ. Recommendations for asthma monitoring in children: A PeARL document endorsed by APAPARI, EAACI, INTERASMA, REG, and WAO. Pediatr Allergy Immunol 2024; 35:e14129. [PMID: 38664926 DOI: 10.1111/pai.14129] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/05/2024] [Revised: 03/22/2024] [Accepted: 03/25/2024] [Indexed: 05/08/2024]
Abstract
Monitoring is a major component of asthma management in children. Regular monitoring allows for diagnosis confirmation, treatment optimization, and natural history review. Numerous factors that may affect disease activity and patient well-being need to be monitored: response and adherence to treatment, disease control, disease progression, comorbidities, quality of life, medication side-effects, allergen and irritant exposures, diet and more. However, the prioritization of such factors and the selection of relevant assessment tools is an unmet need. Furthermore, rapidly developing technologies promise new opportunities for closer, or even "real-time," monitoring between visits. Following an approach that included needs assessment, evidence appraisal, and Delphi consensus, the PeARL Think Tank, in collaboration with major international professional and patient organizations, has developed a set of 24 recommendations on pediatric asthma monitoring, to support healthcare professionals in decision-making and care pathway design.
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Affiliation(s)
- Nikolaos G Papadopoulos
- Division of Infection, Immunity and Respiratory Medicine, School of Biological Sciences, The University of Manchester, Manchester, UK
- Allergy Department, 2nd Paediatric Clinic, National and Kapodistrian University of Athens, Athens, Greece
| | - Adnan Custovic
- Department of Pediatrics, Imperial College London, London, UK
| | - Antoine Deschildre
- Univ. Lille, Pediatric Pulmonology and Allergy Department, Hôpital Jeanne de Flandre, CHU Lille, Lille cedex, France
| | - James E Gern
- Department of Pediatrics and Medicine, University of Wisconsin School of Medicine and Public Health, Madison, Wisconsin, USA
| | - Antonio Nieto Garcia
- Pediatric Pulmonology & Allergy Unit Children's Hospital la Fe, Health Research Institute La Fe, Valencia, Spain
| | - Michael Miligkos
- Allergy Department, 2nd Paediatric Clinic, National and Kapodistrian University of Athens, Athens, Greece
| | - Wanda Phipatanakul
- Children's Hospital Boston, Pediatric Allergy and Immunology, Boston, Massachusetts, USA
| | - Gary Wong
- Department of Pediatrics, Faculty of Medicine, The Chinese University of Hong Kong, Sha Tin, Hong Kong
| | - Paraskevi Xepapadaki
- Allergy Department, 2nd Paediatric Clinic, National and Kapodistrian University of Athens, Athens, Greece
| | - Ioana Agache
- Allergy & Clinical Immunology, Transylvania University, Brasov, Romania
| | - Stefania Arasi
- Allergy Department, Bambino Gesù Children's Hospital, IRCCS, Rome, Italy
| | - Zeinab Awad El-Sayed
- Pediatric Allergy, Immunology and Rheumatology Unit, Children's Hospital, Ain Shams University, Cairo, Egypt
| | - Leonard B Bacharier
- Division of Allergy, Immunology, and Pulmonary Medicine, Department of Pediatrics, Monroe Carell Jr Children's Hospital at Vanderbilt University Medical Center, Nashville, Tennessee, USA
| | - Matteo Bonini
- Department of Cardiovascular and Pulmonary Sciences, Università Cattolica del Sacro Cuore, Rome, Italy
- National Heart and Lung Institute (NHLI), Imperial College London, London, UK
| | - Fulvio Braido
- University of Genoa, Genoa, Italy
- Respiratory Diseases and Allergy Department, Research Institute and Teaching Hospital San Martino, Genoa, Italy
- Interasma - Global Asthma Association (GAA)
| | - Davide Caimmi
- Allergy Unit, CHU de Montpellier, Montpellier, France
- IDESP, UA11 INSERM-Universitè de Montpellier, Montpellier, France
| | - Jose A Castro-Rodriguez
- Department of Pediatrics Pulmonology, School of Medicine, Pontifical Universidad Catolica de Chile, Santiago, Chile
| | - Zhimin Chen
- Pulmonology Department, Children's Hospital Zhejiang University School of Medicine, Hangzhou, China
| | - Michael Clausen
- Children's Hospital, Landspitali University Hospital, Reykjavik, Iceland
| | - Timothy Craig
- Department of Allergy and Immunology, Penn State University, Hershey, Pennsylvania, USA
- Vinmec International Hospital, Hanoi, Vietnam
| | - Zuzana Diamant
- Department of Clinical Pharmacy & Pharmacology, University of Groningen, University Medical Center of Groningen and QPS-NL, Groningen, The Netherlands
- Department of Pediatrics and of Social and Preventive Medicine, University of Montreal, Montreal, Québec, Canada
| | - Francine M Ducharme
- National Hospital Organization Sagamihara National Hospital, Sagamihara, Kanagawa, Japan
| | - Motohiro Ebisawa
- Department of Women-Children-Teenagers, University Hospital of Geneva, Geneva, Switzerland
| | - Philippe Eigenmann
- Department of Pediatric Respiratory Diseases and Allergy, The Medical University of Warsaw, Warsaw, Poland
| | - Wojciech Feleszko
- Pediatric Respiratory and Allergy Units, "Virgen de la Arrixaca" Children's University Clinical Hospital, University of Murcia, Murcia, Spain
| | - Vincezo Fierro
- Allergy Department, Bambino Gesù Children's Hospital, IRCCS, Rome, Italy
| | - Alessandro Fiocchi
- Allergy Department, Bambino Gesù Children's Hospital, IRCCS, Rome, Italy
| | - Luis Garcia-Marcos
- Department of Pediatrics, Respiratory Medicine Service, KK Women's and Children's Hospital, Singapore City, Singapore
| | - Anne Goh
- Faculty of Health Sciences, Catholic University of Salta, Salta, Argentina
| | | | - Maia Gotua
- Children's Center Bethel, Evangelical Hospital Bethel, University of Bielefeld, Bielefeld, Germany
| | - Eckard Hamelmann
- Paediatric Allergy, Centre for Allergy Research, Karolinska Institutet, Solna, Sweden
| | - Gunilla Hedlin
- Department of Allergology and Clinical Immunology, Kazakh National Medical University, Almaty, Kazakhstan
| | - Elham M Hossny
- Pediatric Allergy, Immunology and Rheumatology Unit, Children's Hospital, Ain Shams University, Cairo, Egypt
| | - Zhanat Ispayeva
- Department of Pediatrics, University of Wisconsin School of Medicine and Public Health, Madison, Wisconsin, USA
| | - Daniel J Jackson
- Department of Pediatrics, Turku University Hospital and University of Turku, Turku, Finland
| | - Tuomas Jartti
- Department of Pediatrics, Jessenius Faculty of Medicine in Martin, Center for Vaccination in Special Situations, University Hospital in Martin, Comenius University in Bratislava, Bratislava, Slovakia
| | - Miloš Jeseňák
- Department of Clinical Immunology and Allergology, Jessenius Faculty of Medicine in Martin, Center for Vaccination in Special Situations, University Hospital in Martin, Comenius University in Bratislava, Bratislava, Slovakia
- Pediatric Allergy and Asthma Unit, Hacettepe University School of Medicine, Ankara, Turkey
| | - Omer Kalayci
- Chair Family Physician Airways Group of Canada, Ontario, Canada
| | - Alan Kaplan
- Astrid Lindgren Children's Hospital, Karolinska University Hospital, Stockholm, Sweden
| | - Jon R Konradsen
- Department of Internal Medicine, Asthma and Allergy, Medical University of Lodz, Lodz, Poland
| | - Piotr Kuna
- Charité Universitätsmedizin Berlin, Pediatric Respiratpry Medicine, Immunology and Intensive Care Medicine, Berlin, Germany
| | - Susanne Lau
- School of Medicine, University of Western Australia, Perth, Western Australia, Australia
| | - Peter Le Souef
- Department of Pediatrics and Medicine, University of Wisconsin School of Medicine and Public Health, Madison, Wisconsin, USA
| | - Robert F Lemanske
- Division of Paediatric Allergy, Department of Paediatrics, University of Cape Town, Cape Town, South Africa
| | - Michael Levin
- inVIVO Planetary Health Group of the Worldwide Universities Network
- Department of Allergy, Helsinki University Central Hospital, Helsinki, Finland
| | - Mika J Makela
- North West Lung Centre, Wythenshawe Hospital, Manchester University NHS Foundation Trust, Manchester, UK
| | - Alexander G Mathioudakis
- Division of Infection, Immunity and Respiratory Medicine, School of Biological Sciences, The University of Manchester, Manchester, UK
- First Pediatric Department of Pediatrics, National Pirogov Memorial Medical University, Vinnytsia Children's Regional Hospital, Vinnytsia Oblast, Ukraine
| | | | | | - Clare Murray
- Division of Infection, Immunity and Respiratory Medicine, School of Biological Sciences, The University of Manchester, Manchester, UK
| | | | - Zoltan Novak
- Department of Pediatrics, Nippon Medical School, Tokyo, Japan
| | - Ruby Pawankar
- Division of Respiratory Medicine and Allergology, Department of Pediatrics, Erasmus University Medical Centre - Sophia Children's Hospital, Rotterdam, The Netherlands
| | - Marielle W Pijnenburg
- Allergy Center, CUF Descobertas Hospital and CUF Tejo HospitalInfante Santo Hospital, Lisbon, Portugal
| | - Helena Pite
- NOVA Medical School, Universidade NOVA de Lisboa, Lisbon, Portugal
- Pulmonary Division, Hospital Santa Casa de Porto Alegre, Porto Alegre, Brazil
| | - Paulo M Pitrez
- Pediatric Pulmonology, Pediatric Department, 2nd Faculty of Medicine, Charles University, Prague, Czech Republic
| | - Petr Pohunek
- University Hospital Motol, Prague, Czech Republic
| | - David Price
- Division of Applied Health Sciences, Centre of Academic Primary Care, University of Aberdeen, Aberdeen, UK
- Observational and Pragmatic Research Institute, Singapore City, Singapore
| | - Alfred Priftanji
- Department of Allergy, Mother Theresa School of Medicine, University of Tirana, Tirana, Albania
| | - Valeria Ramiconi
- The European Federation of Allergy and Airways Diseases Patients' Associations (EFA), Brussels, Belgium
| | | | - Graham Roberts
- Paediatric Allergy and Respiratory Medicine within Medicine at the University of Southampton, Southampton, UK
| | - Aziz Sheikh
- Asthma UK Centre for Applied Research, Usher Institute of Population Health Sciences and Informatics, The University of Edinburgh, Edinburgh, UK
| | - Kun-Ling Shen
- Department of Respiratory Medicine, Beijing Children's Hospital, Capital Medical University, National Center for Children's Health, China
| | - Zsolt Szepfalusi
- Division of Pediatric Pulmonology, Allergy and Endocrinologyneumology, Department of Pediatrics and Juvenile Medicine, Comprehensive Center Pediatrics, Medical University of Vienna, Vienna, Austria
| | - Ioanna Tsiligianni
- Health Planning Unit, Department of Social Medicine, Faculty of Medicine, University of Crete, Crete, Greece
| | | | - Steve Turner
- Medical School of Catholic University of Croatia, Zagreb, Croatia
| | - Tetiana Umanets
- Child Health, Royal Aberdeen Children's Hospital and University of Aberdeen, Aberdeen, UK
- Department of Respiratory Diseases and Respiratory Allergy in Children, SI "Institute of Pediatrics, Obstetrics and Gynecology named after Academician O. Lukjanova of NAMS of Ukraine, Kyiv, Ukraine
| | - Arunas Valiulis
- Clinic of Children's Diseases, Institute of Clinical Medicine, Medical Faculty of Vilnius University, Vilnius, Lithuania
| | - Susanne Vijveberg
- Department of Paediatric Pulmonology, Amsterdam Public Health Research Institute, Amsterdam University Medical Centers, University of Amsterdam, Amsterdam, The Netherlands
| | - Jiu-Yao Wang
- China Medical University Children's Hospital Taichung, Taichung, Taiwan
| | | | - Dong Keon Yon
- Department of Pediatrics, Kyung Hee University Medical Center, Kyung Hee University College of Medicine, Seoul, South Korea
| | | | - Heather J Zar
- Department of Pediatrics & Child Health, Director MRC Unit on Child & Adolescent Health, Red Cross War Memorial Children's Hospital, University of Cape Town, Cape Town, South Africa
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Aggelidis X, Kritikou M, Makris M, Miligkos M, Papapostolou N, Papadopoulos NG, Xepapadaki P. Tele-Monitoring Applications in Respiratory Allergy. J Clin Med 2024; 13:898. [PMID: 38337592 PMCID: PMC10856055 DOI: 10.3390/jcm13030898] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/10/2024] [Revised: 01/26/2024] [Accepted: 01/30/2024] [Indexed: 02/12/2024] Open
Abstract
Respiratory allergic diseases affect over 500 million people globally and pose a substantial burden in terms of morbidity, mortality, and healthcare costs. Restrictive factors such as geographical disparities, infectious pandemics, limitations in resources, and shortages of allergy specialists in underserved areas impede effective management. Telemedicine encompasses real-time visits, store-and-forward option triage, and computer-based technologies for establishing efficient doctor-patient communication. Recent advances in digital technology, including designated applications, informative materials, digital examination devices, wearables, digital inhalers, and integrated platforms, facilitate personalized and evidence-based care delivery. The integration of telemonitoring in respiratory allergy care has shown beneficial effects on disease control, adherence, and quality of life. While the COVID-19 pandemic accelerated the adoption of telemedicine, certain concerns regarding technical requirements, platform quality, safety, reimbursement, and regulatory considerations remain unresolved. The integration of artificial intelligence (AI) in telemonitoring applications holds promise for data analysis, pattern recognition, and personalized treatment plans. Striking the balance between AI-enabled insights and human expertise is crucial for optimizing the benefits of telemonitoring. While telemonitoring exhibits potential for enhancing patient care and healthcare delivery, critical considerations have to be addressed in order to ensure the successful integration of telemonitoring into the healthcare landscape.
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Affiliation(s)
- Xenofon Aggelidis
- Allergy Unit, 2nd Department of Dermatology and Venereology, Medical School, Attikon University Hospital, National and Kapodistrian University of Athens, 15772 Athens, Greece; (X.A.); (M.M.); (N.P.)
| | - Maria Kritikou
- Allergy Department, 2nd Pediatric Clinic, National and Kapodistrian University of Athens, 15772 Athens, Greece; (M.M.); (N.G.P.); (P.X.)
| | - Michael Makris
- Allergy Unit, 2nd Department of Dermatology and Venereology, Medical School, Attikon University Hospital, National and Kapodistrian University of Athens, 15772 Athens, Greece; (X.A.); (M.M.); (N.P.)
| | - Michael Miligkos
- Allergy Department, 2nd Pediatric Clinic, National and Kapodistrian University of Athens, 15772 Athens, Greece; (M.M.); (N.G.P.); (P.X.)
| | - Niki Papapostolou
- Allergy Unit, 2nd Department of Dermatology and Venereology, Medical School, Attikon University Hospital, National and Kapodistrian University of Athens, 15772 Athens, Greece; (X.A.); (M.M.); (N.P.)
| | - Nikolaos G. Papadopoulos
- Allergy Department, 2nd Pediatric Clinic, National and Kapodistrian University of Athens, 15772 Athens, Greece; (M.M.); (N.G.P.); (P.X.)
| | - Paraskevi Xepapadaki
- Allergy Department, 2nd Pediatric Clinic, National and Kapodistrian University of Athens, 15772 Athens, Greece; (M.M.); (N.G.P.); (P.X.)
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