Telemedicine use for pediatric asthma care: a mixed methods study.

Objectives: To identify factors associated with telemedicine use for asthma care among children and young adults, and to describe the parent and patient experience of asthma care over telemedicine.

Methods: Our mixed methods study consisted of an electronic health record analysis and a qualitative focus group analysis. We analyzed records for all patients aged 2-24 seen at UC Davis Health between March 19, 2020 and September 30, 2020 for a primary diagnosis of asthma. We performed multivariable logistic regression to quantify the relationships between patient characteristics and telemedicine use. We also conducted focus groups with parents and patients who received asthma care during the study period and used qualitative content analysis to identify themes from the transcripts.

Results: 502 patients met the inclusion criteria. Telemedicine use was significantly lower among patients with a primary language other than English (OR = 0.12, 95% CI: 0.025-0.54,  = 0.006), school-aged children (OR = 0.43, 95% CI: 0.24-0.77,  = 0.005), and patients who received asthma care from a primary care provider instead of a specialist (OR = 0.55, 95% CI: 0.34-0.91,  = 0.020). Six thematic categories emerged from focus groups: engaging with the patient, improving access to care, experience of visit, measurements, scheduling, and the future of telemedicine in asthma care.

Conclusions: Alternating telemedicine with in-person visits for asthma care may result in improved access to care and reduced burdens on patients and families. Providers and researchers should work to understand the specific reasons for low telemedicine use among non-English speaking patients so that these patients receive equitable access to care.