A comparison of web-based and paper-based self management tools for asthma: Patients' opinions and quality of data in a randomised crossover study

• Type: Article in International Scientific Journal
• Date: 2007

Authors

Ricardo Cruz Correia (Author) FMUP; Fonseca, J (Author) FMUP; Lima, L (Author) Other; Araujo, L (Author) Other; Delgado, L (Author) FMUP; Castel Branco, MG (Author) Other; Costa-Pereira A (Author) FMUP

Journal

Title: Journal on Information Technology in Healthcare

Vol. 5

Pages: 357-371

ISSN: 1479-649X

Publisher: Optimum

Indexing

Scopus - 3 Citations

Other information

Authenticus ID: P-009-7YB

Abstract (EN): Objective: The use of information and communication technologies (ICT) may overcome some of the difficulties of conventional, paper-based tools for self-management of chronic diseases, This paper aims to describe and evaluate the use of P'ASMA - a web based asthma self-management support tool in comparison to a paper-based diary. Setting: P'ASMA allows the collection of asthma monitoring data, and provides to both patient and doctor, immediate feedback about an individual patient's condition. For each patient a set of forms and scheduling options can be chosen. The system has been devised for use by asthma patients in Portugal but is applicable to self-management of asthma by patients in other countries. Methods: Twenty-one adults with an established medical diagnosis of asthma were recruited in an exploratory randomised crossover study. Patients used either P'ASMA or a paper asthma diary together with an individual action-plan for a period of 4 weeks after which they crossed over to use the other technique for 4 weeks. Results: Complete data was obtained for 19 of the 21 patients. Patients had a significantly higher adherence to the paper diary compared to P'ASMA, but this may be related to the fact that data could be entered into the paper diary retrospectively and for several days at a time whereas with P'ASMA it could only be entered on the day the data was obtained. Three patients who said they had not completed the paper diary every day had no missing data and 10 patients admitted entering data for several days in the diary in one sitting. Patients preferred P'ASMA to the paper diary. Six patients made positive comments about P'ASMA compared to only 1 for the paper diary, and only two patients made negative remarks about P'ASMA compared to 11 for the paper diary. Twelve patients said they were interested in continuing to monitor their asthma using P'ASMA whereas only 2 were willing to continue to do so with the paper diary (p=0.002). Nineteen problems were reported with the use of PASMA - 9 were related to Internet connections, 5 to the user interface, 3 to internal system errors and 2 to the interpretation of questions. Five patients reported problems related to the paper diary, however only one was of a technical nature (difficult to read), the others were related to easy to "forget to fill in" or lose, or that it was more difficult to understand how their asthma was changing from the paper diary. Conclusions: Patients preferred the web-based application for asthma monitoring and were more willing to continue to use it compared to the paper-based diary, Adherence to the web-based application was much lower than with the paper-based application. However it is not clear if this difference is real as patients were able to enter data in the paper diary retrospectively. The fact that data can not be entered retrospectively in the web-based application means that medical staff can have increased confidence in the integrity and validity of the data obtained from it. © The Journal on Information Technology in Healthcare.

Language: English

Type (Professor's evaluation): Scientific