Internet-based self-management compared with usual care in adolescents with asthma: A randomized controlled trial

Authors

  • E.R.V.M. Rikkers-Mutsaerts MD,

    Corresponding author
    1. Department of Pediatrics, Leiden University Medical Centre, Leiden, The Netherlands
    2. Department of Medical Decision Making, Leiden University Medical Centre, Leiden, The Netherlands
    • Department of Pediatrics, Leiden Universital Medical Centre, J6-S, Albinusdreef 2, 2333 ZA Leiden, The Netherlands.
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  • A.E. Winters RN,

    1. Department of Pediatrics, Leiden University Medical Centre, Leiden, The Netherlands
    2. Department of Medical Decision Making, Leiden University Medical Centre, Leiden, The Netherlands
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  • M.J. Bakker RN,

    1. Department of Medical Decision Making, Leiden University Medical Centre, Leiden, The Netherlands
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  • H.F. van Stel PhD,

    1. Department of Medical Decision Making, Leiden University Medical Centre, Leiden, The Netherlands
    2. Department of Public Health, University Medical Centre Utrecht, Utrecht, The Netherlands
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  • V. van der Meer MD, PhD,

    1. Department of Medical Decision Making, Leiden University Medical Centre, Leiden, The Netherlands
    2. Department of Public Health and Primary Care, Leiden University Medical Centre, Leiden, The Netherlands
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  • J.C. de Jongste MD, PhD,

    1. Department of Pediatric Pulmonology, Erasmus Medical Centre, Sophia Children's Hospital, Rotterdam, The Netherlands
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  • J.K. Sont PhD,

    1. Department of Medical Decision Making, Leiden University Medical Centre, Leiden, The Netherlands
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  • the SMASHING Study Group


  • Conflict of interest: None.

  • Trial Registration: Smashing in adolescents, International Standard Randomized Controlled Trial number: ISRCTN 11633371.

Abstract

Introduction

Asthma control often is poor in adolescents and this causes considerable morbidity. Internet-based self-management (IBSM) improves asthma-related quality of life in adults. We hypothesized that IBSM improves asthma-related quality of life in adolescents.

Methods

Adolescents (12–18 years) with persistent and not well-controlled asthma participated in a randomized controlled trial with 1 year follow-up and were allocated to IBSM (n = 46) or usual care (UC, n = 44). IBSM consisted of weekly asthma control monitoring with treatment advice by a web-based algorithm. Outcomes included asthma-related quality of life (Pediatric Asthma Quality of Life Questionnaire, PAQLQ) and asthma control (Asthma Control Questionnaire, ACQ) and were analyzed by a linear mixed-effects model.

Results

At 3 months, PAQLQ improved with 0.40 points (95% CI: 0.17–0.62, P < 0.01), by IBSM compared to 0.0 points for UC (P = 0.02 for the difference). At 12 months the between-group difference was −0.05 (95% CI: −0.50 to 0.41, P = 0.85). At 3 months ACQ improved more in IBSM than in UC (difference: −0.32 points; 95% CI: −0.56 to −0.079, P < 0.01). At 12 months the difference was −0.05 (95% CI: −0.35 to 0.25, P = 0.75).

Conclusion

IBSM improved asthma-related quality of life and asthma control in adolescents with not well-controlled asthma after 3 months, but not after 12 months. Pediatr Pulmonol. 2012; 47:1170–1179. © 2012 Wiley Periodicals, Inc.

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