Effectiveness of telemedicine in bronchial asthma: a network meta-analysis

This study aimed to synthesize existing evidence comparing telemedicine with usual care and to examine the relative effectiveness of different telemedicine strategies in the management of asthma among adults. A systematic search of MEDLINE/PubMed, Cochrane Library, Web of Science, and Scopus identified randomized clinical trials published from inception until March 16, 2025. Telemedicine interventions were categorized as case management, consultation, education, monitoring, reminding, or combined approaches. Outcomes included asthma control, quality of life (QoL), and medication adherence. Results were synthesized using network meta-analysis and expressed as standardized mean differences (SMDs) or risk ratios (RRs) with 95% confidence intervals (CIs). Thirty-nine trials were included. Compared to usual care, asthma control improved significantly with combined strategies (N = 14; SMD:–0.55; 95%CI:–0.85, −0.25; p N = 3; SMD:–0.62; 95%CI:–1.21, −0.02; p = 0.042), and tele-monitoring (N = 3; SMD:–1.20; 95%CI:–1.97, −0.42; p = 0.003). No significant benefit was found for case management, consultation, or reminder strategies. Based on SUCRA rankings, tele-monitoring, tele-education, and combined approaches were most effective for asthma control. For QoL, combined strategies showed a significant benefit over usual care (SMD:0.32; 95%CI:0.02, 0.62; p = 0.037). SUCRA rankings for QoL placed tele-education first, followed by tele-monitoring and combined strategies. Telemedicine strategies, particularly monitoring, education, and combined approaches, improve asthma control and QoL in adults. However, heterogeneity in intervention design and limited reporting across outcomes suggest cautious interpretation and the need for further research before widespread clinical application.