Monitoring strategies in children with asthma: a randomised controlled trial
Open accessAbstract
BACKGROUND: Asthma guidelines recommend monitoring of asthma control. However, in a substantial proportion of children, asthma is poorly controlled and the best monitoring strategy is not known. OBJECTIVES: We studied two monitoring strategies for their ability to improve asthma outcomes in comparison with standard care (SC): web-based monthly monitoring with the (Childhood) Asthma Control Test (ACT or C-ACT) and 4-monthly monitoring of FENO. METHODS: In this randomised controlled, partly blinded, parallel group multicentre trial with a 1-year follow-up, children aged 4-18 with a doctor's diagnosis of asthma treated in seven hospitals were randomised to one of the three groups. In the web group, treatment was adapted according to ACT obtained via a website at 1-month intervals; in the FENO group according to ACT and FENO, and in the SC group according to the ACT at 4-monthly visits. The primary endpoint was the change from baseline in the proportion of symptom-free days (SFD). RESULTS: Two-hundred and eighty children (mean age 10.4 years, 66% boys) were included; 268 completed the study. Mean changes from baseline in SFD were similar between the groups: -2.1% (web group, n=90), +8.9% (FENO group, n=91) versus 0.15% (SC, n=87), p=0.15 and p=0.78. Daily dose of inhaled corticosteroids (ICS) decreased more in the web-based group compared with both other groups (-200 μg/day, p<0.01), while ACT and SFD remained similar. CONCLUSIONS: The change from baseline in SFD did not differ between monitoring strategies. With web-based ACT monitoring, ICS could be reduced substantially while control was maintained. TRIAL REGISTRATION NUMBER: NTR 1995.
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Another study, not included in the meta-analysis but considered in the sensitivity analysis, revealed a decline in asthma control.
“Another study, not included in the meta-analysis but considered in the sensitivity analysis, revealed a decline in asthma control [78].”
From Effectiveness and Acceptability of Asynchronous Digital Health in Asthma Care: Mixed Methods Systematic Review (2024) · cites this paper as [78]
One child study using the ACT as a continuous variable found no difference in scores between the two monitoring types (MD 0.09, 95% CI -0.92 to 1.10).
“One child study (Voorend-van Bergen 2015) using the Asthma Control Test (ACT) as a continuous variable found no difference in scores between the two types of monitoring (MD 0.09, 95% CI -0.92 to 1.10).”
From Home telemonitoring and remote feedback between clinic visits for asthma (2016) · cites this paper as Voorend-van Bergen 2015
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- Authors
- Voorend-van Bergen, S., Vaessen-Verberne, A. A., Brackel, H. J., Landstra, A. M., van den Berg, N. J., Hop, W. C., de Jongste, J. C., Merkus, P. J., & Pijnenburg, M. W.
- Affiliations
- Amphia Ziekenhuis (NL)
- Catharina Ziekenhuis (NL)
- Rijnstate Hospital (NL)
- Erasmus MC (NL)
- Radboud University Medical Center (NL)
- Venue
- Thorax
- Publisher
- BMJ
- Published
- 2015-03-30
- Volume
- 70
- Issue
- 6
- Pages
- 543-550
- ISSN
- 0040-6376 (ISSN-L)
- 1468-3296
- OpenAlex
- W2122836273
- Cited by
- 66
- References
- 37
- Citations by year
- 2026: 2 · 2025: 2 · 2024: 6 · 2023: 5 · 2022: 5 · 2021: 6 · 2020: 7 · 2019: 4 · 2018: 10 · 2017: 6 · 2016: 9 · 2015: 4
- FWCI
- 7.12
- Type
- journal article
- Language
- en
- Open access
- bronze
- doi.org
- Locations
- Thorax (publishedVersion)
- PubMed (publishedVersion)
- EUR Research Repository (Erasmus University Rotterdam) (submittedVersion)
- Radboud Repository (Radboud University) (submittedVersion)
- Funders
- ZonMw
- Radboud Universiteit
- Radboud Universitair Medisch Centrum
- Erasmus+
- Topics
- Health Sciences › Medicine › Physiology › Asthma and respiratory diseases
- Health Sciences › Medicine › Public Health, Environmental and Occupational Health › Occupational exposure and asthma
- Health Sciences › Medicine › Pulmonary and Respiratory Medicine › Chronic Obstructive Pulmonary Disease (COPD) Research
- Keywords
- childhood asthma, web-based monitoring, Childhood Asthma Control Test, exhaled nitric oxide, inhaled corticosteroids, symptom-free days
- MeSH terms
- Administration, Inhalation, Adolescent, Asthma, Bronchodilator Agents, Child, Child, Preschool, Female, Follow-Up Studies, Glucocorticoids, Humans, Male, Monitoring, Physiologic, Netherlands, Prospective Studies, Quality of Life, Surveys and Questionnaires, Respiratory Function Tests, Single-Blind Method, Treatment Outcome, Budesonide
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