BACKGROUND: The internet may support patient self-management of chronic conditions, such as asthma. OBJECTIVE: To evaluate the effectiveness of internet-based asthma self-management. DESIGN: Randomized, controlled trial. SETTING: 37 general practices and 1 academic outpatient department in the Netherlands. PATIENTS: 200 adults with asthma who were treated with inhaled corticosteroids for 3 months or more during the previous year and had access to the internet. MEASUREMENTS: Asthma-related quality of life at 12 months (minimal clinically significant difference of 0.5 on the 7-point scale), asthma control, symptom-free days, lung function, and exacerbations. INTERVENTION: Participants were randomly assigned by using a computer-generated permuted block scheme to internet-based self-management (n = 101) or usual care (n = 99). The internet-based self-management program included weekly asthma control monitoring and treatment advice, online and group education, and remote web communications. RESULTS: Asthma-related quality of life improved by 0.56 and 0.18 points in the internet and usual care groups, respectively (adjusted between-group difference 0.38 (95% CI 0.20 to 0.56)). An improvement of 0.5 point or more occurred in 54% and 27% of internet and usual care patients, respectively (adjusted relative risk 2.00 (CI 1.38 to 3.04)). Asthma control improved more in the internet group than in the usual care group (adjusted difference -0.47 (CI -0.64 to -0.30)). At 12 months, 63% of internet patients and 52% of usual care patients reported symptom-free days in the previous 2 weeks (adjusted absolute difference 10.9% (CI 0.05% to 21.3%)). Prebronchodilator FEV1 changed with 0.24 L and -0.01 L for internet and usual care patients, respectively (adjusted difference 0.25 L (CI 0.03 to 0.46 L)). Exacerbations did not differ between groups. LIMITATION: The study was unblinded and lasted only 12 months. CONCLUSION: Internet-based self-management resulted in improvements in asthma control and lung function but did not reduce exacerbations, and improvement in asthma-related quality of life was slightly less than clinically significant. PRIMARY FUNDING SOURCE: Netherlands Organization for Health Research and Development, ZonMw, and Netherlands Asthma Foundation.

Full text (sometimes free) may be available at these link(s):      help

• DOI
• PubMed
• PDF locator
• publisher