%0 Journal Article
%@ 2561-6722
%I JMIR Publications
%V 4
%N 4
%P e17959
%T The Role of Education, Monitoring, and Symptom Perception in Internet-Based Self-management Among Adolescents With Asthma: Secondary Analysis of a Randomized Controlled Trial
%A Beerthuizen,Thijs
%A Rikkers-Mutsaerts,E R V M
%A Snoeck-Stroband,Jiska B
%A Sont,Jacob K
%+ Department of Biomedical Data Sciences, Medical Decision Making, Leiden University Medical Center, Albinusdreef 2, J-10-S, Leiden, 2333ZA, Netherlands, 31 715264578, j.k.sont@lumc.nl
%K web-based monitoring
%K internet self-management
%K adolescents
%K asthma
%K education
%K perception
%D 2021
%7 7.12.2021
%9 Original Paper
%J JMIR Pediatr Parent
%G English
%X Background: Internet-based self-management programs improve asthma control and the asthma-related quality of life in adults and adolescents. The components of self-management programs include education and the web-based self-monitoring of symptoms; the latter requires adequate perception in order to timely adjust lifestyle or medication or to contact a care provider. Objective: We aimed to test the hypothesis that adherence to education and web-based monitoring and adequate symptom perception are important determinants for the improvement of asthma control in self-management programs. Methods: We conducted a subgroup analysis of the intervention group of a randomized controlled trial, which included adolescents who participated in the internet-based self-management arm. We assessed the impacts that attendance in education sessions, the frequency of web-based monitoring, and the level of perception had on changes in asthma control (Asthma Control Questionnaire [ACQ]) and asthma-related quality of life (Pediatric Asthma Quality of Life Questionnaire) from baseline to 12 months after intervention. Results: Adolescents who attended education sessions had significant and clinically relevant improvements in asthma control (ACQ score difference: −0.6; P=.03) and exhibited a nonsignificant trend of improvement in asthma-related quality of life (Pediatric Asthma Quality of Life Questionnaire score difference: −0.45; P=.15) when compared to those who did not adhere to education. Frequent monitoring alone did not improve asthma control (P=.07) and quality of life (P=.44) significantly, but its combination with education did result in improved ACQ scores (difference: −0.88; P=.02). There were no significant differences in outcomes between normoperceivers and hypoperceivers. Conclusions: Education, especially in combination with frequent web-based monitoring, is an important determinant for the 1-year outcomes of asthma control in internet-based self-management programs for adolescents with partly controlled and uncontrolled asthma; however, we could not establish the effect of symptom perception. This study provides important knowledge on the effects of asthma education and monitoring in daily life. 
%M 34879001
%R 10.2196/17959
%U https://pediatrics.jmir.org/2021/4/e17959
%U https://doi.org/10.2196/17959
%U http://www.ncbi.nlm.nih.gov/pubmed/34879001