Davos@home: Integrating objective home monitoring into eHealth self-management support after alpine altitude climate treatment for severe asthma.
Fleur L Meulmeester, Femke Paanakker, Lianne Ten Have et al.
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In 30 seconds
This 12-month pragmatic randomised trial assessed whether objective home monitoring adds benefit to eHealth self-management after Alpine Altitude Climate Treatment (AACT) in adults with severe asthma. Participants received eHealth support with or without devices measuring airway inflammation, lung function and activity. Time to first severe exacerbation was similar between groups: median 16.5 weeks (IQR 13–23) with monitoring versus 20 weeks (IQR 16–30) without it (log-rank p = 0.93). A possible reduction in annualised severe exacerbations was not statistically significant, and an early ACQ-6 benefit was not sustained at 12 months.
Key findings
- Time to first severe exacerbation did not differ between groups: 16.5 [13-23] versus 20 [16-30] weeks; log-rank p = 0.93.
- Annualised severe exacerbations showed a non-significant trend favouring monitoring (aRR 0.68, 95%CI 0.45-1.03; p = 0.07).
- ACQ-6 decline was slower with monitoring from baseline to 6 months (β -0.50, 95%CI -0.95;-0.05; p = 0.03), but this difference did not persist to 12 months.
- No effect modification by baseline Fe NO strata was observed, and no intervention-related serious adverse events occurred.
Why it matters
The trial tests whether adding objective measurements to digital self-management can help preserve gains after AACT, when benefits may diminish after patients return home. Its primary result suggests that monitoring devices alone did not delay severe exacerbations or sustain clinical benefit. The findings highlight the distinction between collecting home data and integrating it into support that meaningfully changes ongoing asthma management.
What to keep in mind
Follow-up was 12 months, and 105 of the 143 randomised patients completed follow-up. The primary outcome showed no between-group difference, while the annualised exacerbation result was a non-significant trend.