Accepted for/Published in: JMIR Pediatrics and Parenting
Date Submitted: Jan 24, 2020
Date Accepted: Jun 1, 2021
Date Submitted to PubMed: Dec 8, 2021
Internet-Based Self-Management in Adolescents with Asthma: the Role of Education, Monitoring and Symptom Perception
ABSTRACT
Background:
Internet-based self-management programs improve asthma control and asthma related quality of life in adults and adolescents. Components of self-management programs include education and online self-monitoring of symptoms, the latter requiring adequate perception in order to timely adjust lifestyle or medication or contact a care provider.
Objective:
We hypothesized that adherence to education and online monitoring and adequate symptom perception are important determinants for improvement of asthma control in self-management programs.
Methods:
Subgroup analysis of the intervention group of adolescents who participated in the internet self-management arm of a RCT. Influence of attendance of education sessions, frequency of online monitoring and level of perception on change in asthma control (Asthma Control Questionnaire, ACQ) and asthma related quality of life (Pediatric Asthma Related Quality of Life Questionnaire, PAQLQ), between baseline and 12 months.
Results:
Adolescents attending education sessions had a significant and clinically relevant improvement in asthma control (difference -0.6, P=0.03), and a trend of improvement in asthma related quality of life (difference -0.45, P =0.15) as compared to those who did not follow education. Frequent monitoring alone did not improve ACQ and PAQLQ significantly, but the combination with education did improve ACQ (difference -0.88, P =0.02). There was no difference in outcome between normo- and hypo-perceivers.
Conclusions:
Education, especially in combination with frequent online monitoring is an important determinant for one-year outcome of asthma control in internet-based self-management programs for adolescents with partly and uncontrolled asthma, whilst we could not establish an effect of symptom perception. This provides important knowledge on the effect of asthma education and monitoring in daily life.
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