Effect of a web-based chronic disease management system on asthma control and health-related quality of life: study protocol for a randomized controlled trial
1 School of Physical and Occupational Therapy, McGill University, 3654 Prom. Sir William Osler, Montreal, QC, H3G 1Y5, Canada
2 Clinical and Health Informatics, McGill University, 1140 Pine avenue west, Montreal, QC, H3A 1A3, Canada
3 Dept of Medicine, McGill University, 687 av des Pins Ouest, Montreal, QC, H3A 1A1, Canada
4 Pulmonary Division, Jewish General Hospital, 3755 Côte-Sainte-Catherine Road, Montreal, QC, H3T 1E2, Canada
5 Canada Research Chair in Information Technology in Health Care, HEC Montréal, 3000 Côte-Ste-Catherine Road, QC, H3T 2A7, Canada
6 Education, Concordia University, 1455, de Maisonneuve Blvd W., Montreal, QC, H3G 1M8, Canada
7 Psychiatry, Direction de la santé publique, 1301 rue Sherbrooke est, Montreal, QC, H2L 1M3, Canada
8 Herzl Family Practice Centre, Jewish General Hospital, 3755 Cote Ste Catherine Road, Montreal, QC, H3T 1E2, Canada
9 Canadian Patient Safety Institute, 1150 Cyrville Road, Ottawa, ON, K1J 7S9, Canada
Trials 2011, 12:260 doi:10.1186/1745-6215-12-260Published: 14 December 2011
Asthma 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.
The 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.
Self-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.
Current Controlled Trials ISRCTN34326236.