Guendelman S, Meade K, Benson M, et al. Arch Pediatr Adolesc Med. 2002;156:114–120
Purpose of the Study.
To investigate whether the use of a home-based computerized interactive device using the Internet improves education and self-management of pediatric asthma.
One hundred thirty-four children diagnosed with persistent asthma between 8 and 16 years of age recruited from the primary care clinic at a children’s hospital serving primarily inner-city children.
Randomized, controlled trial with 66 children in the intervention group and 68 children in the control group. Both groups participated in a standardized teaching session on peak flow monitoring and appropriate use of medications. The intervention group received an interactive communication device (Health Buddy) that posed a set of queries each day consisting of symptoms, peak flows, medication use, functional status. The control group monitored their symptoms with a standard asthma diary. All children returned for 2 follow-up visits at 6 and 12 weeks. Measures for the study were compiled from interviews conducted at each visit.
Children in both groups of the study reported a decrease in asthma symptoms and a decrease in peak flow readings in the yellow or red zone at 6 and 12 weeks compared with baseline. Fewer children in the Health Buddy group had yellow or red zone peak flows (P = .02). The intervention group was less likely to report limitation in activity (P = .03), and less likely to make urgent calls to the hospital (P = .05).
Children randomized to the Health Buddy were more likely to improve the degree of compliance with prescribed medications and to reduce asthma symptoms, while making fewer urgent calls.
This study illustrates the need for good asthma education to help reinforce symptom awareness and medication compliance for patients and their families. It is likely that the newly diagnosed and those with a difficult medication regimen would receive greatest benefit. A longer study stratifying patients’ asthma severity would be helpful in pursuit of this idea. One could certainly envision the utility of this type of program in the immediate postexacerbation period, as well as during problematic months. Future studies of the Health Buddy need to address cost-effectiveness and long-term usage.