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Individuals with persistent asthma and at least 1 complex comorbidity were more likely to use telemedicine, the results of the study showed.
More pediatric patients with asthma have been using telemedicine since the COVID-19 pandemic and have been achieving similar outcomes, according to results of a study published in Journal of Allergy and Clinical Immunology: Global. Investigators also found this was particularly true for those with medical complexities and comorbidities, but at their institution, they found Black individuals were less likely to use telemedicine.
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Investigators of the study aimed to determine the trends of usage of telemedicine prior to and through the pandemic, as well as assess the associations between the trends and usage for asthma, according to the study author. They used electronic health records from the University of California, Los Angeles Medical Center for pediatric patients aged 0 through 17 who had an asthma diagnosis 1 year before the pandemic. Three periods were included: March 19, 2019 to February 29, 2020, classified as pre-pandemic; March 1, 2020 to August 31, 2021, classified as early pandemic; and September 1, 2021 to March 31, 2022, classified at current state.
Investigators found that 6777 individuals with asthma had outpatient visits during the study period and 16.5% had at least 1 asthma telemedicine visit. The results showed that individuals with at least 1 asthma-related telemedicine visit were less likely to be Non-Hispanic Black (5.4%) compared with those with no asthma-related telemedicine visit (7.1%). Additionally, there were a high proportion of patients with asthma who visited an office and who preferred Spanish (3.5%) compared with telemedicine (3%), according to the study authors.
Further, those who had mild, moderate, and severe persistent asthma were more likely to visit telemedicine at 13.1%, 22.8%, and 2.9%, respectively, compared to office visits at 8.5%, 8%, and 0.7%, respectively. For those who had intermittent asthma, 41.3% visited an office whereas 38.9% used telemedicine, according to the results of the study.
Investigators also found differences in which medical professionals saw patients via telemedicine and clinics. Approximately 60% of telemedicine visits were conducted by a pulmonologist or allergy/immunology specialist, with only 35% being primary or urgent care physicians. However, more in-person visits took place for primary care and urgent care physicians at 55.3%, while approximately 40% saw a specialist, according to the study authors.
Investigators found that prior to the COVID-19 pandemic, there were only 24-asthma-related telemedicine visits, which increased to 1384 during the first 1.5 years of the pandemic, with approximately 70% of pediatric visits for asthma being telemedicine in April 2020, according to the study authors. Between September 1, 2021, and March 31, 2022, the number of telemedicine visits decreased to 435, but over 10% of asthma-related visits overall remained telemedicine visits. Furthermore, individuals who had at least 1 complex comorbid condition had a higher probability of receiving telemedicine for asthma, according to the study results.
During the pre-pandemic period, approximately 0.38% of all asthma visits were telemedicine, with the early pandemic period consisting of 24.8% of all asthma visits and the current period consisting of 14.9%, according to the study investigators.
Investigators also said that in an unadjusted time-to-event analysis there were only minimal differences in time to first emergency department visit or hospitalization for asthma after an office visit compared to telemedicine.
Reference
Hall K, Kafashzadeh D, Chen L, Dudovitz R, Ross MK. Trends in telemedicine visits among pediatric asthma patients during COVID-19. J Allergy Clin Immunol Global. 2024;100239. doi: https://doi.org/10.1016/j.jacig.2024.100239
