Jacob K. Sont*, Dept. of Medical Decision Making, Leiden University Medical Center, Leiden, Netherlands Johanna L. Van Gaalen, Dept. of Medical Decision Making, Leiden University Medical Center, Leiden, Netherlands Thijs Beerthuizen, Dept. of Medical Decision Making, Leiden University Medical Center, Leiden, Netherlands Jiska Snoeck-stroband, Dept. of Medical Decision Making, Leiden University Medical Center, Leiden, Netherlands Victor Van Der Meer, Dept. of Medical Decision Making, Leiden University Medical Center, Leiden, Netherlands Smashing Study Group, Dept. of Medical Decision Making, Leiden University Medical Center, Leiden, Netherlands Track: Research Presentation Topic: Personal health records and Patient portals Presentation Type: Poster presentation Submission Type: Single Presentation Last modified: 2012-09-11

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Background:
Long-term asthma management falls short of the goals set in international guidelines. The Internet is proposed as an appealing medium to support guided self-management interventions in asthma. In a recent study with a follow-up period of one year, we have shown that internet-based self-management (IBSM) improves asthma-related quality of life, asthma control, lung function and the number of symptom-free days compared to usual care (UC). IBSM consisted of education, electronic monitoring, a personal action plan and communication with a respiratory nurse [Van der Meer, Ann Intern Med 2009]. We hypothesized that the benefits of 1 yr of IBSM support, are sustained over a long-term period.

Methods: 200 adults with doctor diagnosed asthma (>3 mo inhaled corticosteroids prescribed in the past year) from 37 general practices and 1 academic outpatient department, who previously participated, were invited for additional follow-up at 1.5 years after finishing the study. Patients were aged between 18 and 50 years and had Internet access.107 participants completed the Asthma Control Questionnaire (ACQ), Asthma Quality of Life Questionnaire (AQLQ) (both clinically relevant difference 0.5 on the 7-point scale). Pre-bronchodilator lung function (FEV1) was assessed in 66 participants.

Results: A significant and sustained improvement at 30 months after baseline was shown for asthma related quality of life of 0.29 (95% CI 0.01 to 0.57) and asthma control of -0.33 (95% CI -0.61 to -0.05), respectively, in favor of the IBSM group. However, improvement of lung function did not persist in the IBSM group.

Conclusion: Improvements in asthma-related quality of life and asthma control sustained in patients who received internet-based self-management support for one year, even up to 1.5 years after terminating the support. Future research should be focused on implementation of IBSM on a wider scale within routine asthma care.