ERS 2016 Asthma care,eHealth and The Vitual Asthma Clinic

    Wijngaart van den L.S. | UMC Nijmegen | 2 februari 2017 | 7.2.16.139CO (3.4.10.016)

The 26th International congress of the European Respiratory Society was held in London from 3rd to 7thof September 2016. It is the largest respiratory health meeting in the world. The scientific programme of the Congress presented the best in science and educational sessions, covering key topics in respiratory medicine from across the spectrum of disease areas including tuberculosis, lung cancer, pneumonia, cystic fibrosis, COPD, and asthma.

The congress is a good place to build skills and knowledge through hearing the latest news, innovations and topics in the field. By attending the congress I was able to present a poster: 'the virtual asthma clinic for children: description and analysis of website use'. This analysis was conducted as part of a randomized controlled trial on effectiveness of the virtual asthma clinic for children, funded by the Lung Foundation Netherlands (3.4.10.016).

Asthma care, eHealth and The virtual asthma clinic

The growing burden of self-management for patients calls for innovative approaches and eHealth interventions have been proposed as an appealing medium to make patient more aware of their disease and to improve their behaviour accordingly. (1-3). However, studies did only assess whether the addition of eHealth interventions to standard care further improve asthma control, adherence to therapy, general knowledge of asthma or quality of life.(4-6). It has not been investigated whether an eHealth intervention may substitute regular visits to the outpatient clinic and still improve asthma control in children or adolescents. With funding from the Lung foundation Netherlands and Dutch Healthcare Insurers foundation, we developed the virtual asthma clinic for children (VAC), a web-based portal accessible for children and their parents and the asthma management team. It has an information module where children can find information about their disease, and a private secure section, where children can easily communicate with their asthma team, download their individual treatment plan and complete an
asthma control test (ACT). The ACT is a validated questionnaire to assess asthma control, which is the primary aim of asthma management.
Little is known about the actual use of e-health interventions. Therefore, we conducted a retrospective observational study with log-data of the children using the virtual asthma clinic.

Poster presentation

'The virtual asthma clinic for children: description and analvsis of website use. The poster was presented on Tuesday the 6th of September during the thematic poster session and showed our results of the description and analysis of website use of the virtual asthma clinic. This analysis was conducted alongside the randomized controlled trial (RCT). The aim of this RCT was to assess whether asthma control could be improved by care using the VAC, while reducing 50% of the outpatient visits. In this study, 210 children (aged 6-16 years) participated and were randomized in standard care (consisted of 4-monthly outpatient visits) and care using the VAC (8-monthly outpatient visits). After 16 months of follow-up, asthma control was maintained and in subgroups even improved. Website log-data of the 'online-group' were analysed with the aim to describe and analyse the website­ use of children with asthma. Log-data were analysed in retrospect: activity, communication with the medical team and login frequency were compared between different age groups.
Younger children (6-11years) searched significantly more often for information, in particular (general) information, and sent more messages to the asthma team than older children (12-16 years). Most patient initiated discussions were about disease related topics. One third of the children never search for information and 35% did not use the communication module to send messages to their asthma team. Based on these findings we concluded that the virtual asthma clinic was used differently by teenagers
and younger children. The overall login frequency decreased significantly in both age groups, most probable because of the decline of novelty. As one third of all participants did not visit the virtual asthma clinic as often as expected, eHealth interventions may not be suitable for all patients and supports the principle of personalized (e)healthcare. Differences between the two age groups found in our study should be taken into account while designing eHealth interventions for children. To our knowledge, this is the first study describing the detailed use of an eHealth intervention among children with asthma.

Reference

1. Chan DS, Callahan CW, Hatch-Pigott VB, Lawless A, Proffitt HL, Manning NE, et al. lnternet-based home monitoring and education of children with asthma is comparable to ideal office-based care: results of a 1-year asthma in-home monitoring trial. Pediatrics. 2007;119(3):569-78.
2. van der Meer V, van Stel HF, Detmar SB, Otten W, Sterk PJ, Sont JK. lnternet-based self- management offers an opportunity to achieve better asthma control in adolescents. Chest.
2007;132(1):112-9.
3. van Gaalen JL, Beerthuizen T, van der Meer V, van Reisen P, Redelijkheid GW, Snoeck-Stroband JB, et al. Long-term outcomes of internet-based self-management support in adults with asthma: randomized controlled trial. Journal of medical Internet research. 2013;15(9):e188.
4. Voorend-van Bergen S, Vaessen-Verberne AA, Brackel HJ, Landstra AM, van den Berg NJ, Hop
WC, et al. Monitoring strategies in children with asthma: a randomised controlled trial. Thorax.
2015;70(6):543-50.
5. Bussey-Smith KL, Rossen RD. A systematic review of randomized control trials evaluating the effectiveness of interactive computerized asthma patient education programs. Annals of allergy, asthma
& immunology: official publication of the American College of Allergy, Asthma, & Immunology.
2007;98(6):507-16; quiz 16, 66.
6. Runge C, Lecheler J, Horn M, Tews JT, Schaefer M. Outcomes of a Web-based patient education program for asthmatic children and adolescents. Chest. 2006;129(3):581-93.
  

Keyword: ERS 2016 London UK

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