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(Chest. 2006;129:581-593.)
© 2006 American College of Chest Physicians

Outcomes of a Web-Based Patient Education Program for Asthmatic Children and Adolescents*

Claus Runge, PhD; Josef Lecheler, MD; Michael Horn, MD; Jan-Torsten Tews, MD and Marion Schaefer, PhD{dagger}

* From GlaxoSmithKline GmbH & Co. (Drs. Runge and Tews), Munich; CJD Asthmazentrum Berchtesgaden (Dr. Lecheler), Berchtesgaden; Forum Telemedizin GmbH (Dr. Horn), Munich; and Institut of Clinical Pharmacology (Dr. Schaefer), Humboldt-University Berlin, Berlin, Germany. {dagger} A list of participants is given in the Appendix.

Correspondence to: Claus Runge, MD, Kunstwerkerstrasse 179, 45136 Essen, Germany, e-mail: Runge.Claus{at}web.de

Abstract

Background: Asthma is the most common chronic disease among children in Germany. Approaches to reduce the burden of asthma include patient education to improve self-management skills.

Study objectives: We determined whether a continuous Internet-based education program (IEP) as an add-on to a standardized patient management program (SPMP) improves health outcomes of asthma patients at a favorable benefit-cost ratio.

Patients and methods: A total of 438 asthmatic patients aged 8 to 16 years in 36 study centers were enrolled during a 6-month period. We performed a prospective cost-benefit analysis alongside a nonrandomized trial. At baseline and at 6 months and 12 months, health service utilization data were collected.

Interventions: Study participants were assigned to a control group and two intervention groups. Patients in both intervention groups participated in an SPMP. Additionally, patients in one intervention group received the IEP.

Results: Utilization of various health-care services decreased significantly in both intervention groups. From a payer perspective, the benefit-cost ratio of the traditional education program was 0.55. Adding the IEP improved the ratio (0.79). For patients with moderate or severe asthma, the benefit-cost ratios were 1.07 and 1.42 (with IEP), respectively.

Conclusions: The IEP offers the potential to decrease the burden of disease and to realize incremental morbidity cost savings. Subgroup analysis demonstrated that within 1 year, the savings exceed the intervention costs in patients with moderate or severe asthma.

Key Words: asthma • cost-benefit analysis • Internet costs • patient education • quality of life






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