Patients in the intervention groups were allowed to self select the IEP as an additional module. The IEP (www.forum-telemedizin.de, now www.asthmax.de) includes an additional educational module with an asthma-related quiz and an interactive adventure game incorporating numerous virtual asthma-related situations that have to be managed adequately. Furthermore, a repetition section displaying the educational material of the SPMP is included. In addition, the IEP provides a medical module with individual medication plans, scheduled chats with asthma experts, and an on-line peak flow protocol that is to be maintained by the patient. Communication of registered users, both patients and health-care providers, is feasible in chat rooms or by e-mail. Content for the IEP had been developed by a multidisciplinary team. Over a 6-month period, the IEP was tested successfully in a focus group including 50 children in an inpatient setting. read
Eligibility criteria for study participation were age between 8 and 16 years and the presence of a confirmed asthma diagnosis for at least 1 year. No other asthma program participation prior to study entry was allowed. Sufficient knowledge of the German language was assumed. Appropriate information about the concept of the study was given to all patients and their caregivers by the investigators, and informed consent was obtained from all participants (intervention and control groups) before study entry.
Physician- and caregiver-reported resource-use data for asthma care were collected. The primary study outcome measure was the calculation of a benefit-cost ratio for each intervention strategy from both the perspective of health-care insurance and a societal perspective. Prices were adjusted to year 2001 prices. Since the observational period did not exceed 1 year, neither prices nor outcomes were discounted. Secondary outcome measures included QoL, lung function, use of rescue medication, and number of days absent from school due to asthma.