Abstract
BackgroundAsthma is a prevalent and costly disease resulting in reduced quality of life for a large proportion of individuals. Effective patient self-management is critical for improving health outcomes. However, key aspects of self-management such as self-monitoring of behaviours and symptoms, coupled with regular feedback from the health care team, are rarely addressed or integrated into ongoing care. Health information technology (HIT) provides unique opportunities to facilitate this by providing a means for two way communication and exchange of information between the patient and care team, and access to their health information, presented in personalized ways that can alert them when there is a need for action. The objective of this study is to evaluate the acceptability and efficacy of using a web-based self-management system, My Asthma Portal (MAP), linked to a case-management system on asthma control, and asthma health-related quality of life.MethodsThe trial is a parallel multi-centered 2-arm pilot randomized controlled trial. Participants are randomly assigned to one of two conditions: a) MAP and usual care; or b) usual care alone. Individuals will be included if they are between 18 and 70, have a confirmed asthma diagnosis, and their asthma is classified as not well controlled by their physician. Asthma control will be evaluated by calculating the amount of fast acting beta agonists recorded as dispensed in the provincial drug database, and asthma quality of life using the Mini Asthma Related Quality of Life Questionnaire. Power calculations indicated a needed total sample size of 80 subjects. Data are collected at baseline, 3, 6, and 9 months post randomization. Recruitment started in March 2010 and the inclusion of patients in the trial in June 2010.DiscussionSelf-management support from the care team is critical for improving chronic disease outcomes. Given the high volume of patients and time constraints during clinical visits, primary care physicians have limited time to teach and reinforce use of proven self-management strategies. HIT has the potential to provide clinicians and a large number of patients with tools to support health behaviour change.Trial RegistrationCurrent Controlled Trials ISRCTN34326236.
Highlights
Asthma is a prevalent and costly disease resulting in reduced quality of life for a large proportion of individuals
The objective of this study is to evaluate the acceptability and test the efficacy of using My Asthma Portal (MAP) linked to a case-management system on asthma control, and on asthma healthrelated quality of life
We hypothesize that higher rates of usage of MAP will be associated with greater improvements in asthma control and asthma-related quality of life
Summary
Asthma is a prevalent and costly disease resulting in reduced quality of life for a large proportion of individuals. Key aspects of self-management such as self-monitoring of behaviours and symptoms, coupled with regular feedback from the health care team, are rarely addressed or integrated into ongoing care. Much of the cost of asthma care is attributable to poor disease control due to non-adherence to prophylactic therapies, inadequate monitoring of disease severity, and insufficient patient education for effective self-management [1]. Effective management requires a strong collaborative partnership between patients and their care team. Barriers to building effective partnerships between patients and the care team include lack of patient time and engagement, reduced continuity of care, limited patient self-monitoring of symptoms, and minimal follow-up between visits by the care team [14,15,16]
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