Effectiveness of digital health technology interventions for patients with asthma: a systematic review and meta-analysis

Objective Asthma is a common chronic respiratory disease, and digital health technologies (DHTs) are increasingly used in its management. However, prior studies lack a comprehensive qualitative and quantitative synthesis of DHTs' specific role in asthma care. Methods We systematically searched PubMed, Embase, Cochrane Library, Web of Science, Ovid, and Scopus for English-language literature on asthma and DHTs from inception to October 15, 2026. Mean differences were extracted for continuous outcomes. Event counts and sample sizes were extracted for dichotomous outcomes to calculate risk ratios (RRs) and 95% confidence intervals (CIs). Heterogeneity was assessed using Cochran's Q -test and the I 2 statistic. Subgroup analyses were conducted, and Egger's test and the trim-and-fill method were used for exploratory analyses. Results We included 22 studies involving 3,581 asthma patients. Following DHT interventions, Asthma Control Test (ACT) scores increased (WMD = 4.64 points, 95% CI: 3.87 to 5.41), as did Asthma Quality of Life Questionnaire (AQLQ) scores (WMD = 0.34 points, 95% CI: 0.19 to 0.49) and forced expiratory volume in 1 s expressed as a percentage of the predicted value (FEV1% predicted) (WMD = 8.48, 95% CI: 5.90 to 11.05). Fractional exhaled nitric oxide (FeNO) levels decreased (WMD = −14.41 ppb, 95% CI: −16.55 to −12.28). The change in peak expiratory flow expressed as a percentage of the predicted value (PEF% predicted) was not statistically significant (WMD = 10.67, 95% CI: −7.38 to 28.73). Between-group comparisons showed no significant differences in the risk of emergency department (ED) visits (RR = 0.86, 95% CI: 0.68 to 1.09, P = 0.210) or risk of hospitalization (RR = 0.73, 95% CI: 0.45 to 1.16). Whether the proportion of patients meeting medication adherence criteria increased remained uncertain. Conclusion The pooled findings suggest that DHTs, as an adjunct to asthma treatment, may improve physiological markers (FeNO levels, FEV1% predicted) and subjective metrics (ACT scores, AQLQ scores). However, their effects on PEF% predicted, acute healthcare utilization, and medication adherence remain uncertain. Further high-quality prospective studies are needed to establish their long-term clinical benefits. Systematic Review Registration http://INPLASY.com identifier INPLASY202660041.