WEARCON: Wearable home monitoring in children with asthma reveals a strong association with hospital based assessment of asthma control.

Abstract

Background: Asthma is one of the most common chronic diseases in childhood. Regular follow-up of physiological parameters in the home setting, in relation to asthma symptoms, can provide complementary quantitative insights into the dynamics of the asthma status. Despite considerable interest in asthma home-monitoring in children, there is a paucity of scientific evidence, especially on multi-parameter monitoring approaches. Therefore, the aim of this study is to investigate whether asthma control can be accurately assessed in the home situation by combining parameters from respiratory physiology sensors.Methods: Sixty asthmatic and 30 non-asthmatic children were enrolled in the observational WEARCON-study. Asthma control was assessed according to GINA guidelines by the paediatrician. All children were also evaluated during a 2-week home-monitoring period with wearable devices; a physical activity tracker, a handheld spirometer, smart inhalers, and an ambulatory electrocardiography device to monitor heart and respiratory rate. Multiple logistic regression analysis was used to determine which diagnostic measures were associated asthma control.Results: 24 of the 27 uncontrolled asthmatic children and 29 of the 32 controlled asthmatic children could be accurately identified with this model. The final model showed that a larger variation in pre-exercise lung function (OR=1.34 95%-CI 1.07-1.68), an earlier wake-up-time (OR=1.05 95%-CI 1.01-1.10), more reliever use (OR=1.11 95%-CI 1.03-1.19) and a longer respiratory rate recovery time (OR=1.12 95%-CI 1.05-1.20) were significant contributors to the probability of having uncontrolled asthma.Conclusions: Home-monitoring of physiological parameters correlates with paediatrician assessed asthma control. The constructed multivariate model identifies 88.9% of all uncontrolled asthmatic children, indicating a high potential for monitoring of asthma control. This may allow healthcare professionals to assess asthma control at home.Trial registration: Netherlands Trail Register, NL6087. Registered 14 February 2017, https://www.trialregister.nl/trial/6087