Online asthma management for children is cost-effective
Authors: Lara S. van den Wijngaart, Wietske Kievit, Jolt Roukema, Annemie L.M. Boehmer, Marianne L. Brouwer, Cindy A.C. Hugen, Laetitia E.M. Niers, Arwen J. Sprij, Eleonora R.V.M. Rikkers-Mutsaerts, Bart L. Rottier, Chris M. Verhaak, Mariëlle W. Pijnenburg, Peter J.F.M. Merkus
Journal: European Respiratory Journal (2017)

eHealth interventions have been proposed as an appealing method to improve health outcomes and reduce healthcare costs [1–3]. However, the development of an eHealth intervention is associated with high costs and this investment needs to be balanced by increased clinical effectiveness and related cost savings. Unfortunately, solid evidence for the effectiveness of eHealth with regard to health improvement is still limited [2–5], as is evidence regarding cost-effectiveness. This causes uncertainty about the effectiveness of eHealth and constitutes a barrier towards successful implementation in daily practice [6, 7]. Thus, it is necessary to assess both effectiveness and cost-effectiveness to convince colleagues and policymakers of its added value. Online asthma management in children can (partly) substitute routine outpatient visits and is cost-effective <http://ow.ly/oabk30f7Sre> Author roles: Merkus, Peter; Pijnenburg, Mariëlle; Verhaak, Chris designed the study and obtained funding. van den Wijngaart, Lara; Roukema, Jolt; Boehmer, Annemie; Brouwer, Marianne; Verhaak, Chris; Niers, Laetitia; Sprij, Arwen; Rikkers-Mutsaerts, Eleonora; Rottier, Bart; Pijnenburg, Mariëlle; Merkus, Peter all participated as investigators, recruited patients and performed treatments. van den Wijngaart, Lara carried out the analyses. Kievit, Wietske conducted the cost-effectiveness analysis. van den Wijngaart, Lara; Kievit, Wietske; Roukema, Jolt; Merkus, Peter operated as the writing committee and drafted the manuscript until it reached its final form. All authors commented on the manuscript and its revisions. Merkus, Peter is the guarantor of the study. Ethical approval: This study was approved by all local ethics committees. All participants provided written informed consent. Data sharing: Patient-level data are available on reasonable request from the corresponding author. Patient consent was not obtained but the data presented are anonymised and risk of identification is absent. Transparency declaration: The lead author affirms that this manuscript is an honest, accurate and transparent account of the study being reported, that no important aspects of the study have been omitted, and that any discrepancies from the study as planned (and, if relevant, registered) have been explained. Prior presentations: Results of this randomised controlled trial were presented at the Congress of the European Respiratory Society (Amsterdam, 2015). Results of the cost-effectiveness analysis were presented at the Congress of International Paediatric Pulmonology (Naples, 2016). Thanks: We are grateful to all the participating children and parents for their contribution to this study, as well as collaborating paediatricians and Sintnicolaas, Coosje (Radboud University Medical Centre, Amalia Children's Hospital, Department of Paediatric Pulmonology, Nijmegen, The Netherlands); Stevens, Petra (Canisius Wilhelmina Hospital, Department of Paediatrics, Nijmegen, The Netherlands); Verwaal, Mariël (Maasstad Hospital, Department of Paediatrics, Rotterdam, The Netherlands); Bolder, Carola (Maxima Medical Centre, Department of Paediatrics, Veldhoven, The Netherlands); Winters, Ans (Leiden University Medical Centre, Department of Paediatric Pulmonology, Leiden, The Netherlands); Mulder, Ineke and van Baak, Christine (both Haga Hospital, Juliana Children's Hospital, Department of Paediatric Pulmonology, The Hague, The Netherlands); Spierings, Magda and Hiddinga, Jantine (both Erasmus Medical Centre, Sophia Children's Hospital and Kinderhaven/Havenziekenhuis, Department of Paediatric Pulmonology, Rotterdam, The Netherlands) for their enthusiasm and their efforts in recruiting and monitoring the patients. We acknowledge Hop, Wim (Erasmus Medical Centre, Department of Biostatistics, Rotterdam, The Netherlands) and Moll, Henriëtte (Erasmus Medical Centre, Sophia Children's Hospital, Department of Paediatrics, Rotterdam, The Netherlands) for performing the interim safety analysis and also commemorate van Gent, Rene (Maxima Medical Centre, Department of Paediatrics, Veldhoven, The Netherlands) and thank him for his contributions to this study.