TY - JOUR
T1 - A virtual asthma clinic for children
T2 - Fewer routine outpatient visits, same asthma control
AU - van den Wijngaart, Lara S.
AU - Roukema, Jolt
AU - Boehmer, Annemie L. M.
AU - Brouwer, Marianne L.
AU - Hugen, Cindy A. C.
AU - Niers, Laetitia E. M.
AU - Sprij, Arwen J.
AU - Rikkers-Mutseerts, Eleanore R. V. M.
AU - Rottier, Bart L.
AU - Donders, A. Rogier T.
AU - Verhaak, Chris M.
AU - Pijnenburg, Marlette W.
AU - Merkus, Peter J. F. M.
PY - 2017/10/1
Y1 - 2017/10/1
N2 - eHealth is an appealing medium to improve healthcare and its value (in addition to standard care) has been assessed in previous studies. We aimed to assess whether an eHealth intervention could improve asthma control while reducing 50% of routine outpatient visits.In a multicentre, randomised controlled trial with a 16-month follow-up, asthmatic children (616 years) treated in eight Dutch hospitals were randomised to usual care (4-monthly outpatient visits) and online care using a virtual asthma clinic (VAC) (8-monthly outpatient visits with monthly web-based monitoring). Outcome measures were the number of symptom-free days in the last 4 weeks of the study, asthma control, forced expiratory volume in 1 s, exhaled nitric oxide fraction, asthma exacerbations, unscheduled outpatient visits, hospital admissions, daily dose of inhaled corticosteroids and courses of systemic corticosteroids.We included 210 children. After follow-up, symptom-free days differed statistically between the usual care and VAC groups (difference of 1.23 days, 95% CI 0.42-2.04; p= 0.003) in favour of the VAC. In terms of asthma control, the Childhood Asthma Control Test improved more in the VAC group (difference of 1.17 points, 95% CI 0.09-2.25; p= 0.03). No differences were found for other outcome measures.Routine outpatient visits can partly be replaced by monitoring asthmatic children via eHealth.
AB - eHealth is an appealing medium to improve healthcare and its value (in addition to standard care) has been assessed in previous studies. We aimed to assess whether an eHealth intervention could improve asthma control while reducing 50% of routine outpatient visits.In a multicentre, randomised controlled trial with a 16-month follow-up, asthmatic children (616 years) treated in eight Dutch hospitals were randomised to usual care (4-monthly outpatient visits) and online care using a virtual asthma clinic (VAC) (8-monthly outpatient visits with monthly web-based monitoring). Outcome measures were the number of symptom-free days in the last 4 weeks of the study, asthma control, forced expiratory volume in 1 s, exhaled nitric oxide fraction, asthma exacerbations, unscheduled outpatient visits, hospital admissions, daily dose of inhaled corticosteroids and courses of systemic corticosteroids.We included 210 children. After follow-up, symptom-free days differed statistically between the usual care and VAC groups (difference of 1.23 days, 95% CI 0.42-2.04; p= 0.003) in favour of the VAC. In terms of asthma control, the Childhood Asthma Control Test improved more in the VAC group (difference of 1.17 points, 95% CI 0.09-2.25; p= 0.03). No differences were found for other outcome measures.Routine outpatient visits can partly be replaced by monitoring asthmatic children via eHealth.
KW - RANDOMIZED CONTROLLED-TRIAL
KW - RESPIRATORY-SOCIETY STATEMENT
KW - CHILDHOOD ASTHMA
KW - SELF-MANAGEMENT
KW - MONITORING STRATEGIES
KW - LUNG-FUNCTION
KW - ADOLESCENTS
KW - EDUCATION
KW - OUTCOMES
KW - VALIDATION
U2 - 10.1183/13993003.00471-2017
DO - 10.1183/13993003.00471-2017
M3 - Article
SN - 0903-1936
VL - 50
JO - European Respiratory Journal
JF - European Respiratory Journal
IS - 4
M1 - 1700471
ER -