Findings from a pilot randomised trial of an asthma internet self-management intervention (RAISIN)

Morrison, D. , Wyke, S. , Saunderson, K., McConnachie, A. , Agur, K., Chaudhuri, R. , Thomas, M., Thomson, N.C., Yardley, L. and Mair, F.S. (2016) Findings from a pilot randomised trial of an asthma internet self-management intervention (RAISIN). BMJ Open, 6(5), e009254. (doi: 10.1136/bmjopen-2015-009254) (PMID:27173807) (PMCID:PMC4874112)

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Abstract

<b>Objective </b>To evaluate the feasibility of a phase 3 randomised controlled trial (RCT) of a website (Living Well with Asthma) to support self-management.<p></p> <b>Design and setting</b> 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.<p></p> <b>Participants </b>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.<p></p> <b>Intervention</b> 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.<p></p> <b>Outcome measures</b> 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.<p></p> <b>Results </b>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.<p></p> <b>Conclusions</b> 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.

Item Type:Articles
Additional Information:Paper acknowledges CSO CAF/11/08
Status:Published
Refereed:Yes
Glasgow Author(s) Enlighten ID:Wyke, Professor Sally and Morrison, Dr Deborah and Thomson, Professor Neil and Saunderson, Dr Kathryn and Agur, Dr Karolina and McConnachie, Professor Alex and Mair, Professor Frances and Chaudhuri, Dr Rekha
Authors: Morrison, D., Wyke, S., Saunderson, K., McConnachie, A., Agur, K., Chaudhuri, R., Thomas, M., Thomson, N.C., Yardley, L., and Mair, F.S.
College/School:College of Medical Veterinary and Life Sciences > Institute of Health and Wellbeing > General Practice and Primary Care
College of Medical Veterinary and Life Sciences > Institute of Infection Immunity and Inflammation
Journal Name:BMJ Open
Publisher:BMJ Publishing Group
ISSN:2044-6055
ISSN (Online):2044-6055
Copyright Holders:Copyright © 2015 The Authors
First Published:First published in BMJ Open 6(5): e009254
Publisher Policy:Reproduced under a Creative Commons License

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