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Evaluation of a web-based asthma self-management system: a randomised controlled pilot trial.

Wiecha JM, Adams WG, Rybin D, Rizzodepaoli M, Keller J, Clay JM - BMC Pulm Med (2015)

Bottom Line: After 6-months, reported wheezing improved significantly in both intervention and control groups, and there were significant improvements in the intervention group only in night-time awakening and parental loss of sleep, but there were no significant differences between intervention and control groups in these measures.Among the subgroup of subjects with low controller medication adherence at baseline, adherence improved significantly only in the intervention group.Knowledge of the purpose of controller medicine increased significantly in the intervention group, a statistically significant improvement over the control group.

View Article: PubMed Central - PubMed

Affiliation: Boston University School of Medicine, 72 East Concord St., B2900, Boston, MA, 02118-2518, USA. john383@bu.edu.

ABSTRACT

Background: Asthma is the most common chronic condition of childhood and disproportionately affects inner-city minority children. Low rates of asthma preventer medication adherence is a major contributor to poor asthma control in these patients. Web-based methods have potential to improve patient knowledge and medication adherence by providing interactive patient education, monitoring of symptoms and medication use, and by facilitation of communication and teamwork among patients and health care providers. Few studies have evaluated web-based asthma support environments using all of these potentially beneficial interventions. The multidimensional website created for this study, BostonBreathes, was designed to intervene on multiple levels, and was evaluated in a pilot trial.

Methods: An interactive, engaging website for children with asthma was developed to promote adherence to asthma medications, provide a platform for teamwork between caregivers and patients, and to provide primary care providers with up-to-date symptom information and data on medication use. Fifty-eight (58) children primarily from inner city Boston with persistent-level asthma were randomised to either usual care or use of BostonBreathes. Subjects completed asthma education activities, and reported their symptoms and medication use. Primary care providers used a separate interface to monitor their patients' website use, their reported symptoms and medication use, and were able to communicate online via a discussion board with their patients and with an asthma specialist.

Results: After 6-months, reported wheezing improved significantly in both intervention and control groups, and there were significant improvements in the intervention group only in night-time awakening and parental loss of sleep, but there were no significant differences between intervention and control groups in these measures. Emergency room or acute visits to a physician for asthma did not significantly change in either group. Among the subgroup of subjects with low controller medication adherence at baseline, adherence improved significantly only in the intervention group. Knowledge of the purpose of controller medicine increased significantly in the intervention group, a statistically significant improvement over the control group.

Conclusions: This pilot study suggests that a multidimensional web-based educational, monitoring, and communication platform may have positive influences on pediatric patients' asthma-related knowledge and use of asthma preventer medications.

No MeSH data available.


Related in: MedlinePlus

BostonBreathes patient home page.
© Copyright Policy - open-access
Related In: Results  -  Collection

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getmorefigures.php?uid=PMC4355974&req=5

Fig1: BostonBreathes patient home page.

Mentions: After logging in with a password, subjects completed asthma education activities in a guided, deliberate sequence starting with reporting of asthma symptoms and impairment (see “Functions Supported by the BostonBreathes Websites” section). Completion of each function earned points, displayed on a counter on the webpage, which were redeemable for gift cards to a department store. Each data point entered was acknowledged by an interpretive response of the website: peak flow was coded according to action plan zone, and the website responded to symptoms data entered, or in response to a report of an appropriate level of use of controller medications, with facial expression tags (See Figure 1 for a screen capture of the patient’s web interface).Figure 1


Evaluation of a web-based asthma self-management system: a randomised controlled pilot trial.

Wiecha JM, Adams WG, Rybin D, Rizzodepaoli M, Keller J, Clay JM - BMC Pulm Med (2015)

BostonBreathes patient home page.
© Copyright Policy - open-access
Related In: Results  -  Collection

License 1 - License 2
Show All Figures
getmorefigures.php?uid=PMC4355974&req=5

Fig1: BostonBreathes patient home page.
Mentions: After logging in with a password, subjects completed asthma education activities in a guided, deliberate sequence starting with reporting of asthma symptoms and impairment (see “Functions Supported by the BostonBreathes Websites” section). Completion of each function earned points, displayed on a counter on the webpage, which were redeemable for gift cards to a department store. Each data point entered was acknowledged by an interpretive response of the website: peak flow was coded according to action plan zone, and the website responded to symptoms data entered, or in response to a report of an appropriate level of use of controller medications, with facial expression tags (See Figure 1 for a screen capture of the patient’s web interface).Figure 1

Bottom Line: After 6-months, reported wheezing improved significantly in both intervention and control groups, and there were significant improvements in the intervention group only in night-time awakening and parental loss of sleep, but there were no significant differences between intervention and control groups in these measures.Among the subgroup of subjects with low controller medication adherence at baseline, adherence improved significantly only in the intervention group.Knowledge of the purpose of controller medicine increased significantly in the intervention group, a statistically significant improvement over the control group.

View Article: PubMed Central - PubMed

Affiliation: Boston University School of Medicine, 72 East Concord St., B2900, Boston, MA, 02118-2518, USA. john383@bu.edu.

ABSTRACT

Background: Asthma is the most common chronic condition of childhood and disproportionately affects inner-city minority children. Low rates of asthma preventer medication adherence is a major contributor to poor asthma control in these patients. Web-based methods have potential to improve patient knowledge and medication adherence by providing interactive patient education, monitoring of symptoms and medication use, and by facilitation of communication and teamwork among patients and health care providers. Few studies have evaluated web-based asthma support environments using all of these potentially beneficial interventions. The multidimensional website created for this study, BostonBreathes, was designed to intervene on multiple levels, and was evaluated in a pilot trial.

Methods: An interactive, engaging website for children with asthma was developed to promote adherence to asthma medications, provide a platform for teamwork between caregivers and patients, and to provide primary care providers with up-to-date symptom information and data on medication use. Fifty-eight (58) children primarily from inner city Boston with persistent-level asthma were randomised to either usual care or use of BostonBreathes. Subjects completed asthma education activities, and reported their symptoms and medication use. Primary care providers used a separate interface to monitor their patients' website use, their reported symptoms and medication use, and were able to communicate online via a discussion board with their patients and with an asthma specialist.

Results: After 6-months, reported wheezing improved significantly in both intervention and control groups, and there were significant improvements in the intervention group only in night-time awakening and parental loss of sleep, but there were no significant differences between intervention and control groups in these measures. Emergency room or acute visits to a physician for asthma did not significantly change in either group. Among the subgroup of subjects with low controller medication adherence at baseline, adherence improved significantly only in the intervention group. Knowledge of the purpose of controller medicine increased significantly in the intervention group, a statistically significant improvement over the control group.

Conclusions: This pilot study suggests that a multidimensional web-based educational, monitoring, and communication platform may have positive influences on pediatric patients' asthma-related knowledge and use of asthma preventer medications.

No MeSH data available.


Related in: MedlinePlus