Evaluation of a web-based XXXX self-management system: a randomised controlled pilot trial.

@entity1 @entity565 @entity25
BACKGROUND: Asthma is the most common chronic condition of childhood and disproportionately affects inner-city minority @entity1 . Low rates of @entity565 preventer medication adherence is a major contributor to poor @entity565 control in these @entity1 . Web-based methods have potential to improve @entity1 knowledge and medication adherence by providing interactive @entity1 education, monitoring of symptoms and medication use, and by facilitation of communication and teamwork among @entity1 and health care providers. Few studies have evaluated web-based @entity565 support environments using all of these potentially beneficial interventions. The multidimensional website created for this study, BostonBreathes, was designed to intervene on multiple levels, and was evaluated in a pilot trial. METHODS: An interactive, engaging website for @entity1 with @entity565 was developed to promote adherence to @entity565 medications, provide a platform for teamwork between caregivers and @entity1 , and to provide primary care providers with up-to-date symptom information and data on medication use. Fifty-eight (58) @entity1 primarily from inner city Boston with persistent-level @entity565 were randomised to either usual care or use of BostonBreathes. Subjects completed @entity565 education activities, and reported their symptoms and medication use. Primary care providers used a separate interface to monitor their @entity1 ' website use, their reported symptoms and medication use, and were able to communicate online via a discussion board with their @entity1 and with an @entity565 specialist. RESULTS: After 6-months, reported wheezing improved significantly in both intervention and control groups, and there were significant improvements in the intervention group only in night-time awakening and @entity25 , but there were no significant differences between intervention and control groups in these measures. Emergency room or acute visits to a physician for @entity565 did not significantly change in either group. Among the subgroup of subjects with low controller medication adherence at baseline, adherence improved significantly only in the intervention group. Knowledge of the purpose of controller medicine increased significantly in the intervention group, a statistically significant improvement over the control group. CONCLUSIONS: This pilot study suggests that a multidimensional web-based educational, monitoring, and communication platform may have positive influences on pediatric @entity1 ' @entity565 -related knowledge and use of @entity565 preventer medications.
