Long-Term Outcomes of Internet-Based Self-Management Support in Adults With Asthma: Randomized Controlled Trial
BackgroundLong-term asthma management falls short of the goals set by international guidelines. The Internet is proposed as an attractive medium to support guided self-management in asthma. Recently, in a multicenter, pragmatic randomized controlled parallel trial with a foll...
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doaj-be574f36dc3c422d8f7e4559083337782021-04-02T21:35:57ZengJMIR PublicationsJournal of Medical Internet Research1438-88712013-09-01159e18810.2196/jmir.2640Long-Term Outcomes of Internet-Based Self-Management Support in Adults With Asthma: Randomized Controlled Trialvan Gaalen, Johanna LBeerthuizen, Thijsvan der Meer, Victorvan Reisen, PatriciaRedelijkheid, Geertje WSnoeck-Stroband, Jiska BSont, Jacob K BackgroundLong-term asthma management falls short of the goals set by international guidelines. The Internet is proposed as an attractive medium to support guided self-management in asthma. Recently, in a multicenter, pragmatic randomized controlled parallel trial with a follow-up period of 1 year, patients were allocated Internet-based self-management (IBSM) support (Internet group [IG]) or usual care (UC) alone. IBSM support was automatically terminated after 12 months of follow-up. In this study, IBSM support has been demonstrated to improve asthma-related quality of life, asthma control, lung function, and the number of symptom-free days as compared to UC. IBSM support was based on known key components for effective self-management and included weekly asthma control monitoring and treatment advice, online and group education, and communication (both online and offline) with a respiratory nurse. ObjectiveThe objective of the study was to assess the long-term effects of providing patients 1 year of IBSM support as compared to UC alone. MethodsTwo hundred adults with physician-diagnosed asthma (3 or more months of inhaled corticosteroids prescribed in the past year) from 37 general practices and 1 academic outpatient department who previously participated were invited by letter for additional follow-up at 1.5 years after finishing the study. The Asthma Control Questionnaire (ACQ) and the Asthma Quality of Life Questionnaire (AQLQ) were completed by 107 participants (60 UC participants and 47 IG participants). A minimal clinical important difference in both questionnaires is 0.5 on a 7-point scale. ResultsAt 30 months after baseline, a sustained and significant difference in terms of asthma-related quality of life of 0.29 (95% CI 0.01-0.57) and asthma control of -0.33 (95% CI -0.61 to -0.05) was found in favor of the IBSM group. No such differences were found for inhaled corticosteroid dosage or for lung function, measured as forced expiratory volume in 1 second. ConclusionsImprovements in asthma-related quality of life and asthma control were sustained in patients who received IBSM support for 1 year, even up to 1.5 years after terminating support. Future research should be focused on implementation of IBSM on a wider scale within routine asthma care. Trial RegistrationInternational Standard Randomized Controlled Trial Number (ISRCTN): 79864465; http://www.controlled-trials.com/ISRCTN79864465 (Archived by WebCite at http://www.webcitation.org/6J4VHhPk4).http://www.jmir.org/2013/9/e188/ |
collection |
DOAJ |
language |
English |
format |
Article |
sources |
DOAJ |
author |
van Gaalen, Johanna L Beerthuizen, Thijs van der Meer, Victor van Reisen, Patricia Redelijkheid, Geertje W Snoeck-Stroband, Jiska B Sont, Jacob K |
spellingShingle |
van Gaalen, Johanna L Beerthuizen, Thijs van der Meer, Victor van Reisen, Patricia Redelijkheid, Geertje W Snoeck-Stroband, Jiska B Sont, Jacob K Long-Term Outcomes of Internet-Based Self-Management Support in Adults With Asthma: Randomized Controlled Trial Journal of Medical Internet Research |
author_facet |
van Gaalen, Johanna L Beerthuizen, Thijs van der Meer, Victor van Reisen, Patricia Redelijkheid, Geertje W Snoeck-Stroband, Jiska B Sont, Jacob K |
author_sort |
van Gaalen, Johanna L |
title |
Long-Term Outcomes of Internet-Based Self-Management Support in Adults With Asthma: Randomized Controlled Trial |
title_short |
Long-Term Outcomes of Internet-Based Self-Management Support in Adults With Asthma: Randomized Controlled Trial |
title_full |
Long-Term Outcomes of Internet-Based Self-Management Support in Adults With Asthma: Randomized Controlled Trial |
title_fullStr |
Long-Term Outcomes of Internet-Based Self-Management Support in Adults With Asthma: Randomized Controlled Trial |
title_full_unstemmed |
Long-Term Outcomes of Internet-Based Self-Management Support in Adults With Asthma: Randomized Controlled Trial |
title_sort |
long-term outcomes of internet-based self-management support in adults with asthma: randomized controlled trial |
publisher |
JMIR Publications |
series |
Journal of Medical Internet Research |
issn |
1438-8871 |
publishDate |
2013-09-01 |
description |
BackgroundLong-term asthma management falls short of the goals set by international guidelines. The Internet is proposed as an attractive medium to support guided self-management in asthma. Recently, in a multicenter, pragmatic randomized controlled parallel trial with a follow-up period of 1 year, patients were allocated Internet-based self-management (IBSM) support (Internet group [IG]) or usual care (UC) alone. IBSM support was automatically terminated after 12 months of follow-up. In this study, IBSM support has been demonstrated to improve asthma-related quality of life, asthma control, lung function, and the number of symptom-free days as compared to UC. IBSM support was based on known key components for effective self-management and included weekly asthma control monitoring and treatment advice, online and group education, and communication (both online and offline) with a respiratory nurse.
ObjectiveThe objective of the study was to assess the long-term effects of providing patients 1 year of IBSM support as compared to UC alone.
MethodsTwo hundred adults with physician-diagnosed asthma (3 or more months of inhaled corticosteroids prescribed in the past year) from 37 general practices and 1 academic outpatient department who previously participated were invited by letter for additional follow-up at 1.5 years after finishing the study. The Asthma Control Questionnaire (ACQ) and the Asthma Quality of Life Questionnaire (AQLQ) were completed by 107 participants (60 UC participants and 47 IG participants). A minimal clinical important difference in both questionnaires is 0.5 on a 7-point scale.
ResultsAt 30 months after baseline, a sustained and significant difference in terms of asthma-related quality of life of 0.29 (95% CI 0.01-0.57) and asthma control of -0.33 (95% CI -0.61 to -0.05) was found in favor of the IBSM group. No such differences were found for inhaled corticosteroid dosage or for lung function, measured as forced expiratory volume in 1 second.
ConclusionsImprovements in asthma-related quality of life and asthma control were sustained in patients who received IBSM support for 1 year, even up to 1.5 years after terminating support. Future research should be focused on implementation of IBSM on a wider scale within routine asthma care.
Trial RegistrationInternational Standard Randomized Controlled Trial Number (ISRCTN): 79864465; http://www.controlled-trials.com/ISRCTN79864465 (Archived by WebCite at http://www.webcitation.org/6J4VHhPk4). |
url |
http://www.jmir.org/2013/9/e188/ |
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