Towards non-invasive home monitoring of children with asthma, a clinical cohort study

<bold>Background:</bold> Uncontrolled asthma in children can significantly impair quality of life, highlighting the importance of effective symptom monitoring for achieving good asthma control. However, regular clinical follow-up does not meet the natural course of asthma. Therefore, the objective of this study was to evaluate whether digital home monitoring including non-invasive measurements of vital parameters can detect early disease deterioration and improve asthma control. <bold>Methods:</bold> In this twelve-week study, 40 children with asthma between 6-18 years of age received digital follow-up. Patients were monitored using the Luscii application, a smartwatch (Fitbit charge 5) and a home spirometer (MIR Spirobank). Vital parameters were collected continuously, (Children) Asthma Control Test ((C)-ACT) at least monthly and lung function at least weekly. Medical feedback was provided based on predefined cut-off values. Logistic regression analysis, Wilcoxon and paired T-test were used. <bold>Results:</bold> Logistic regression analysis showed a significant association between an increase in nighttime heart rate and deterioration in (C)-ACT scores (p=0.009, CI -1.258 – -0.181), corrected for the use of Salbutamol. Furthermore, no significant association was observed between lung function and (C)-ACT. The C-ACT scores tend to improve during the study period (median C-ACT T1: 22.5 versus T0: 24, p=0.063). No significant improvement in lung function was found compared to baseline. Discussion A step closer to non-invasive home monitoring was taken by demonstrating the association between an increase in nighttime heart rate and worsening (C)-ACT scores. Moreover, a non-significant improvement of C-ACT scores was observed.