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Respiratory medicine
Research
Findings from a pilot Randomised trial of an Asthma Internet Self-management Intervention (RAISIN)
  1. D Morrison1,
  2. S Wyke2,
  3. K Saunderson1,
  4. A McConnachie2,3,
  5. K Agur1,
  6. R Chaudhuri4,
  7. M Thomas5,
  8. N C Thomson4,
  9. L Yardley6,
  10. F S Mair1
  1. 1General Practice & Primary Care, Institute of Health & Wellbeing, University of Glasgow, Glasgow, UK
  2. 2Institute of Health and Wellbeing/Interdisciplinary Research Professor, College of Social Sciences, University of Glasgow, Glasgow, UK
  3. 3Robertson Centre for Biostatistics, Institute of Health and Wellbeing, University of Glasgow, Glasgow, UK
  4. 4Institute of Infection, Immunity and Inflammation, Gartnavel General Hospital, University of Glasgow, Glasgow, UK
  5. 5Primary Care Research, Aldermoor Health Centre, University of Southampton, Southampton, UK
  6. 6Department of Psychology, University of Southampton, Southampton, UK
  1. Correspondence to Dr FS Mair; Frances.Mair{at}glasgow.ac.uk

Abstract

Objective To evaluate the feasibility of a phase 3 randomised controlled trial (RCT) of a website (Living Well with Asthma) to support self-management.

Design and setting Phase 2, parallel group, RCT, participants recruited from 20 general practices across Glasgow, UK. Randomisation through automated voice response, after baseline data collection, to website access for minimum 12 weeks or usual care.

Participants Adults (age≥16 years) with physician diagnosed, symptomatic asthma (Asthma Control Questionnaire (ACQ) score ≥1). People with unstable asthma or other lung disease were excluded.

Intervention ‘Living Well with Asthma’ is a desktop/laptop compatible interactive website designed with input from asthma/ behaviour change specialists, and adults with asthma. It aims to support optimal medication management, promote use of action plans, encourage attendance at asthma reviews and increase physical activity.

Outcome measures Primary outcomes were recruitment/retention, website use, ACQ and mini-Asthma Quality of Life Questionnaire (AQLQ). Secondary outcomes included patient activation, prescribing, adherence, spirometry, lung inflammation and health service contacts after 12 weeks. Blinding postrandomisation was not possible.

Results Recruitment target met. 51 participants randomised (25 intervention group). Age range 16–78 years; 75% female; 28% from most deprived quintile. 45/51 (88%; 20 intervention group) followed up. 19 (76% of the intervention group) used the website, for a mean of 18 min (range 0–49). 17 went beyond the 2 ‘core’ modules. Median number of logins was 1 (IQR 1–2, range 0–7). No significant difference in the prespecified primary efficacy measures of ACQ scores (−0.36; 95% CI −0.96 to 0.23; p=0.225), and mini-AQLQ scores (0.38; −0.13 to 0.89; p=0.136). No adverse events.

Conclusions Recruitment and retention confirmed feasibility; trends to improved outcomes suggest use of Living Well with Asthma may improve self-management in adults with asthma and merits further development followed by investigation in a phase 3 trial.

Trial registration number ISRCTN78556552; Results.

  • Internet
  • PRIMARY CARE
  • Adherence
  • behaviour change
  • complex intervention

This is an Open Access article distributed in accordance with the terms of the Creative Commons Attribution (CC BY 4.0) license, which permits others to distribute, remix, adapt and build upon this work, for commercial use, provided the original work is properly cited. See: http://creativecommons.org/licenses/by/4.0/

https://doi.org/10.1136/bmjopen-2015-009254

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