Self-Management of Asthma Supported by Hospitals, Information and communication technology, Nurses and General practitioners (SMASHING in adults)

ISRCTN ISRCTN79864465
DOI https://doi.org/10.1186/ISRCTN79864465
Secondary identifying numbers N/A
Submission date
09/01/2006
Registration date
09/01/2006
Last edited
16/09/2013
Recruitment status
No longer recruiting
Overall study status
Completed
Condition category
Respiratory
Prospectively registered
Protocol
Statistical analysis plan
Results
Individual participant data

Plain English Summary

Not provided at time of registration

Contact information

Dr Victor Meer, van der
Scientific

Leiden University Medical Center
Department of Medical Decision Making
J-10-87
P.O. Box 9600
Leiden
2300 RC
Netherlands

+31 (0)71 5264904
V.van_der_Meer@lumc.nl

Study information

Study designRandomised controlled trial
Primary study designInterventional
Secondary study designRandomised controlled trial
Study setting(s)Other
Study typeQuality of life
Participant information sheet Not available in web format, please use the contact details below to request a patient information sheet
Scientific title
Study acronymSMASHING in adults
Study hypothesisA self-management programme guided by doctors and a specialist asthma nurse through information and communication technology will improve asthma related quality of life in a cost-effective way.
Ethics approval(s)Not provided at time of registration
ConditionAsthma
InterventionA 12-month intervention period where the patients receive either ‘usual care’ or ‘ICT-supported care’ guided by a specialised asthma nurse and doctor.

Care strategies:
1. Usual care
According to the Dutch GP guidelines, patients are invited to visit their general practitioner every 3 months in order to titrate medication to the lowest level that is needed to maintain control. This frequency can be lowered to 1-2 visits per year once control of asthma has been achieved.
Thirty percent of general practices have nurse practitioners providing self-management education. Patients are referred to a chest physician if sufficient control is not achieved within 3 months. Exacerbations of asthma are treated by either chest physician and general practitioner.
1. Advise to visit to general practitioner or specialist to assess present situation
2. Review medication devices technique and adherence
3. Issue and explain paper asthma action plan, monitoring of lung function with Piko-1 spirometer
4. Plan next doctor visits as needed

2. ICT-supported care
1. Weekly monitoring of asthma control questionnaire (ACQ) and lung function through webpages and/or SMS with feedback
2. At least 6 weeks daily monitoring of lung function and symptoms with electronic feedback through webpages and/or SMS
3. Asthma self-management education in small groups (2x) by trained asthma specialist nurse (see below):
i. Discussion of ACQ data in order to assess present situation and electronic asthma action plan
ii. Review medication devices technique and adherence
iii. Plan next doctor visits as needed
4. Virtual consulting room with asthma nurse via private messaging
5. Social support within a private chatbox and/or internet support group
6. Automated sending of reminders via email and/or SMS
7. Monitoring asthma control by lung function and ACQ with electronic data processing and feedback through computer via webpages with graphical presentation of data for patient and nurse
Intervention typeOther
Primary outcome measure1. Asthma related quality of life
2. Measurement instrument: asthma quality of life questionnaire (AQLQ)
3. Evaluation at baseline, after 3 months and after 12 months
Secondary outcome measures1. Asthma control
2. Symptom free days
3. Exacerbations
4. Health care utilisation
5. Absence of work/school
6. Lung function
7. Exhaled nitric oxide
8. Medication use
9. Side effects
Overall study start date01/01/2006
Overall study end date01/03/2008

Eligibility

Participant type(s)Patient
Age groupAdult
Lower age limit18 Years
Upper age limit50 Years
SexBoth
Target number of participants250
Participant inclusion criteria1. 250 patients with mild persistent to moderate asthma (prevalent cases)
2. Age 18-50 years
3. Doctor's diagnosis of asthma
4. Asthma severity step 2-3, patients who need inhaled corticosteroids as controller medication (at least 3 months in the past year)
5. PC with internet connection available
6. Able to communicate in the Dutch language
Participant exclusion criteria1. Patients with intermittent asthma
2. Patients with severe asthma
3. Use of oral glucocorticosteroids as controller medication
4. Serious co-morbidity interfering with asthma or treatment of asthma
5. No PC or no internet connection
6. Not able to communicate in the Dutch language
Recruitment start date01/01/2006
Recruitment end date01/03/2008

Locations

Countries of recruitment

  • Netherlands

Study participating centre

Leiden University Medical Center
Leiden
2300 RC
Netherlands

Sponsor information

Leiden University Medical Center (LUMC) (Netherlands)
Not defined

Albinusdreef 2
P.O. Box 9600
Leiden
2300 RC
Netherlands

ROR logo https://ror.org/05xvt9f17

Funders

Funder type

Research council

Netherlands Organisation for Health Research and Development (ZonMw)
Private sector organisation / Other non-profit organizations
Alternative name(s)
Netherlands Organisation for Health Research and Development
Location
Netherlands
Netherlands Asthma Foundation

No information available

Results and Publications

Intention to publish date
Individual participant data (IPD) Intention to shareNo
IPD sharing plan summaryNot provided at time of registration
Publication and dissemination planNot provided at time of registration
IPD sharing plan

Study outputs

Output type Details Date created Date added Peer reviewed? Patient-facing?
Results article results 21/07/2009 Yes No
Results article results 10/06/2010 Yes No
Results article results 01/06/2011 Yes No
Results article results 12/09/2013 Yes No
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