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Internet based self-management offers an opportunity to achieve better asthma control in adolescents

¹Dept of Medical Decision Making and Dept of Public Health and Primary Care, Leiden University Medical Center ²Dept of Medical Decision Making, Leiden University Medical Center ³TNO Quality of Life, Leiden ⁴Dept of Pulmonology, Leiden University Medical Center ⁵Dept of Medical Decision Making, Leiden University Medical Center and the SMASHING Study Group

V.van_der_Meer{at}lumc.nl

Abstract

Background:Internet and short message service are emerging tools in chronic disease management of adolescents, but few data exist on barriers and benefits of internet-based asthma self-management. Our objective was to reveal perceived barriers and benefits by adolescents with well and poorly controlled asthma to current and internet-based asthma management.

MethodsNinety-seven adolescents with mild to moderate persistent asthma monitored asthma control on a designated website. After four weeks 35 adolescents participated in eight focus groups. Participants were stratified on age, gender and asthma control level. We used qualitative and quantitative methods to analyze the written focus group transcripts.

ResultsLimited self-efficacy to control asthma was a significant barrier to current asthma management in adolescents with poor asthma control (65%) compared to adolescents with good asthma control (17%) (p<0.01). The former group revealed several benefits from internet based asthma self-management: feasible electronic monitoring, easily accessible information, email communication and use of an electronic action plan. Personal benefits included the ability to react to change and to optimize asthma control. Patients with poor asthma control were able and ready to incorporate internet based asthma self-management for a long period of time (65%), whereas patients with good control were not (11%) (p<0.01).

ConclusionsOur findings reveal a need for support of self-management in adolescents with poorly controlled asthma that can be met by application of novel information and communication technologies. Internet based self-management should therefore target adolescents with poor asthma control.

Key Words: Asthma • Internet • Self-management • Adolescents