Subject(s)
Ambulatory Care , Asthma , Patient Care Management , Quality of Life , Telemedicine , Adolescent , Airway Management/methods , Ambulatory Care/economics , Ambulatory Care/methods , Asthma/economics , Asthma/psychology , Asthma/therapy , Child , Cost-Benefit Analysis , Female , Humans , Male , Netherlands , Patient Care Management/economics , Patient Care Management/methods , Patient Care Management/standards , Quality Improvement , Surveys and Questionnaires , Telemedicine/economics , Telemedicine/methods , Treatment OutcomeABSTRACT
eHealth is an appealing medium to improve healthcare and its value (in addition to standard care) has been assessed in previous studies. We aimed to assess whether an eHealth intervention could improve asthma control while reducing 50% of routine outpatient visits.In a multicentre, randomised controlled trial with a 16-month follow-up, asthmatic children (6-16â years) treated in eight Dutch hospitals were randomised to usual care (4-monthly outpatient visits) and online care using a virtual asthma clinic (VAC) (8-monthly outpatient visits with monthly web-based monitoring). Outcome measures were the number of symptom-free days in the last 4â weeks of the study, asthma control, forced expiratory volume in 1â s, exhaled nitric oxide fraction, asthma exacerbations, unscheduled outpatient visits, hospital admissions, daily dose of inhaled corticosteroids and courses of systemic corticosteroids.We included 210 children. After follow-up, symptom-free days differed statistically between the usual care and VAC groups (difference of 1.23â days, 95% CI 0.42-2.04; p=0.003) in favour of the VAC. In terms of asthma control, the Childhood Asthma Control Test improved more in the VAC group (difference of 1.17â points, 95% CI 0.09-2.25; p=0.03). No differences were found for other outcome measures.Routine outpatient visits can partly be replaced by monitoring asthmatic children via eHealth.
