Table 2

Overview of included studies

Study type (size)CountryInterventionPopulationDescription of patient support services
Retrospective (N=746)17UKBenralizumabSEA, adults, mean age 54 years- The Connect 360 programme provided patients with education on self-administration, support for at-home administration and adherence support from trained nurses.
Prospective observational (N=104)39USADupilumabSA, age ≥12 years, mean age 51 years- Patients completed surveys for clinical and HRQoL outcomes at baseline and at regular intervals after treatment initiation; PSP description is not provided.
Retrospective (N=50)37ItalyOmalizumab, mepolizumab, benralizumab, dupilumabSA, adults, mean age 52 years- Training for at-home administration, telephone support and remote monitoring were provided and medication was delivered at home.
- Emotional and psychological support to help reduce fear and anxiety.
- Patients treated with benralizumab participated in Connect 360 PSP.
- Majority of patients treated with mepolizumab participated in ‘Aria di Casa’ PSP. For patients unable to self-inject at home, a nurse was appointed to assist with at-home medication delivery and administration.
Prospective observational (N=17)52 53ArgentinaOmalizumabSA, paediatric patients, age ≥6 years, mean age 12 years- Special healthcare modality providing frequent visits, provision of medications at no charge, the development of educational activities.
- Education on environmental control (eg, tobacco use at home and household environmental contaminants), administration techniques and treatment adherence.
- Psychologist-coordinated and physical therapist-coordinated sessions for exercise, physical therapy and relaxation techniques.
Retrospective (N=119)45FranceOmalizumab, other therapies (no other biologics)SA, mean age 51 years- Nurses instructed each patient on proper inhaler administration technique and provided a written action plan.
- Access to a dietitian, a psychologist, a nicotine addiction specialist or a social worker.
- Comorbidity interventions: pulmonary rehabilitation, nocturnal ventilation for obstructive sleeping apnoea, smoking cessation, psychiatric care, nutritional follow-up by a dietitian, sleeve gastrectomy, hyperventilation treatment.
Prospective observational (N=237)33–36ColombiaOmalizumabSA, mean age 36 years- Educational courses provided monthly by a pharmacist, focusing on proper medication usage and the importance of adherence.
Prospective observational (N=50)32UKMepolizumabSA, mean age NR- Educational sessions provided by a pharmacist focusing on the importance of adherence for patients starting biological therapy.
- Nurses reiterated adherence messages during each visit.
Survey (N=54)54Saudi ArabiaOmalizumab, Mepolizumab, DupilumabSA, mean age 47 years- Patients responded to a cross-sectional survey that inquired about their experiences with telemedicine during the COVID-19 pandemic.
Registry (N=NR)55DenmarkNRSA, mean age NR- An application allowing remote collection and monitoring of PROs. An upcoming expansion of the smartphone application will monitor the at-home administration (reminders for patients, administration records, side effects and an action plan for exacerbations).
Prospective observational (N=19)43RussiaOmalizumabAsthma, paediatric, mean age 14 years- A patient-to-doctor interface was developed allowing remote telecommunication.
- Patients can ask questions, enter peak flow levels, symptoms, basic therapy and rescue medication, and symptoms.
- Specialists can access data on patient condition, adherence and asthma control.
Survey (N=167)56ItalyMepolizumab, omalizumab, benralizumab, dupilumabSA, adults, treated with biologics, mean age 55 years- Telemedicine programme including quarterly virtual visits, providing patients with spirometer and oxyhaemoglobin saturation metre for at-home measurements.
- Patients will be trained on self-administration and performing measurements at home.
Survey (N=120 physicians, 432 patients)57GermanyOmalizumabSA, mainly adults, mean age NR- Multiple-choice survey aimed at understanding how patients regarded the potential at-home administration of biologics, including the level of support they would require to participate in at-home administration.
Prospective, observational (N=25)42USAOmalizumabSEA, adults, mean age NR- Education on self-administration.
Survey (N=26)44AustraliaMepolizumabSEA, mean age NR- Education and training for transitioning to at-home administration.
Qualitative interviews (N=75)58Netherlands, USA, Australia, Northern IrelandBenralizumab, dupilumab, mepolizumab, omalizumab, reslizumabSA, adults, mean age 50 years- The interviews provided insight into the perceptions and experiences of patients and their healthcare providers on at-home administration of biologics for severe asthma. All patients received information and training before transitioning to at-home administration.
Prospective observational (N=10)38ItalyMepolizumab, dupilumab, omalizumab, benralizumabSA and chronic rhinosinusitis with nasal polyps, adults, mean age NR- Patients received training for self-administration and they could communicate to a dedicated nurse in case of questions, concerns or for reporting adverse events.
Prospective observational (N=33)59PortugalOmalizumab, mepolizumab, benralizumab, dupilumabSA, adults, mean age 44 years- Patients were given a questionnaire to assess their acceptance of the at-home administration, perceptions and concerns.
- Patients were trained at the hospital to self-administer the biologic.
- Patients were provided with information support (video or written).
Prospective observational (N=24)60NetherlandsReslizumabSEA, adults, mean age 55 years- Respiratory nurses administered at-home treatment and planned upcoming visits.
- Patients had access to appointment schedules through a patient portal.
- Patients could record symptoms using ACQ via a portal or personal email.
Prospective observational (N=23)31UKOmalizumab/mepolizumabSA, paediatric patients, median age 14 years- Paediatric patients and caregivers were educated and supported on the at-home administration and at-home FEV1 and FVC monitoring.
- Subsequent injections, asthma control and HRQoL were virtually supervised by a clinical nurse specialist; quarterly appointments with consultants occurred virtually.
Prospective observational (N=246)40UKBenralizumabSEA, mean age NR- Patients were surveyed for ACQ-6 responses via telephone, following the transition to homecare.
Prospective observational (N=87)41UKMepolizumabSEA, mean age NR- ACQ-6 was measured in the clinic, and then later by telephone following the transition to homecare.
  • ACQ, Asthma Control Questionnaire; ACT, Asthma Control Test; AQLQ, Asthma Quality of Life Questionnaire; FEV1, forced expiratory volume in one second; FVC, forced vital capacity; HRQoL, health-related quality of life; IgE, immunoglobulin E; NR, not reported; PAQLQ, Paediatric Asthma Quality of Life Questionnaire; PROs, patient-reported outcomes; PSP, patient support programme; SA, severe asthma; SEA, severe eosinophilic asthma; SLR, systematic literature review.