Internet-based self-management in adolescents with asthma: The role of education, monitoring and symptom perception

Background Internet-based self-management (IBSM) programs improve asthma control and asthma related quality of life in adults and adolescents. Education and monitoring of asthma control are important components of the IBSM intervention. Perception of symptoms seems crucial for adequate self-monitoring. Aims We hypothesized that improvement in asthma control and asthma related quality of life by IBSM is positively related to education, frequent monitoring and adequate perception. Methods Subgroup analysis of the intervention group of adolescents (12-18yr) with not well-controlled asthma who participated in a randomized controlled trial of IBSM (SMASHING). Asthma control (Asthma Control Questionnaire, ACQ) and asthma related quality of life (Pediatric Asthma Related Quality of Life Questionnaire, PAQLQ) were measured at baseline and 12 months. Results Adolescents attending education sessions had a significant and clinical relevant improvement in ACQ (difference -0.6, p=0.03), but not in PAQLQ (difference -0.45, p=0.15). Frequent monitoring alone did not improve ACQ and PAQLQ significantly, but the combination with education did improve ACQ (difference -0.88, p=0.02). There was no difference in outcomes between normo- and hypo-perceivers. Conclusion Education, especially in combination with frequent monitoring is an important determinant for asthma control in internet-based self-management programs for adolescents with not well-controlled asthma, whilst level of perception seems not a issue.