Effectiveness of digital health interventions for asthma: a systematic review and meta-analysis.

Asthma, a prevalent chronic respiratory condition, frequently leads to issues like inadequate symptom management, diminished quality of life, and reduced lung function among patients. Proficient self-care plays a pivotal role in symptom control and enhancing quality of life. Digital health interventions have shown promise in enhancing treatment outcomes, mitigating acute exacerbations, and elevating patients' quality of life by enhancing self-management skills. This systematic review and meta-analysis aimed to assess the clinical impact of digital health interventions on asthma management, encompassing asthma control [evaluated using the Asthma Control Test (ACT) and Asthma Control Questionnaire (ACQ)], quality of life [assessed through the Asthma Quality of Life Questionnaire (AQLQ), Mini Asthma Quality of Life Questionnaire (mini-AQLQ), and Pediatric Asthma Quality of Life Questionnaire (PAQLQ)], pulmonary function [including forced expiratory volume in 1 second (FEV1), FEV1/forced vital capacity (FVC), and FEV1% predicted], and health care use indicators (measured by the frequency of hospitalizations and emergency visits). This study used preset search terms to systematically search PubMed, Embase, Cochrane, Scopus, and Web of Science databases until December 31, 2025. Randomized controlled trials on digital health interventions for asthma were screened. Two reviewers independently completed literature screening, data extraction, and bias risk assessment. The results covered asthma control, quality of life, lung function, and health care use indicators. This analysis included 24 randomized controlled trials (RCTs) involving 5,155 participants across nine countries. Among these trials, 18 involved medical professionals utilizing digital platform applications, while two focused on compliance strategies. The digital tools for asthma primarily emphasize self-management systems, which encompass self-monitoring, medication reminders, and the dissemination of health information. The meta-analysis results indicated that digital health interventions significantly improved overall ACT scores [standardized mean difference (SMD) = 0.43, 95% CI: 0.35 to 0.51, P < 0.001]. Significant improvements were also observed at the 3-month follow-up (SMD = 0.45, 95% CI: 0.27 to 0.62, P < 0.001), 6-month follow-up (SMD = 0.41, 95% CI: 0.29 to 0.52, P < 0.001), and 12-month follow-up (SMD = 0.35, 95% CI: 0.04 to 0.65, P = 0.025). Similarly, a significant overall reduction in ACQ scores was associated with digital health interventions (SMD = -0.37, 95% CI: -0.66 to -0.08, P = 0.013), driven primarily by the 12-month follow-up subgroup (SMD = -0.48, 95% CI: -0.82 to -0.13, P = 0.007). In terms of quality of life, digital health intervention can significantly improve the quality of life of patients, overall AQLQ score (SMD = 0.98, 95% CI: 0.49 to 1.47, P < 0.001), 3 months (SMD = 0.55, 95% CI: 0.23 to 0.86, P = 0.001). At 6 months (SMD = 1.41, 95% CI: 1.06 to 1.75, P < 0.001) and 12 months follow-up (SMD = 0.60, 95% CI: 0.35 to 0.85, P < 0.001); the mini-AQLQ score exhibited a modest improvement (SMD = 0.20, 95% CI: 0.06 to 0.34, P = 0.005) at 3 months (SMD = 0.29, 95% CI: 0.02 to 0.55, P = 0.034) and at 12 months (SMD = 0.22, 95% CI: 0.03 to 0.40, P = 0.023). Nevertheless, no significant differences were observed in the Pediatric Asthma Quality of Life Questionnaire, lung function, emergency treatment, or hospitalization risk. Our study suggests that digital health interventions may benefit patient-reported asthma control and quality of life, but have no significant effect on objective physiological indicators or acute healthcare utilization. In the future, high-quality, large-sample and long-term randomized controlled trials are needed to further verify these findings. identifier PROSPERO CRD420251076990, URL: https://www.crd.york.ac.uk/PROSPERO/view/CRD420251076990.