A third of the UK’s 4.3 million adults with asthma have poorly controlled symptoms, and a new trial will test whether their GP can simply point them toward an online community to improve that. Poor asthma control sends 93,000 people to hospital each year, drives 121,000 A&E visits and 6.3 million GP appointments, and costs the NHS £1.1 billion annually. UK asthma death rates are among the worst in Europe. Existing online health communities for asthma exist, but evidence that primary care can effectively promote them—and that doing so improves outcomes—is sparse. This project will co-develop a structured intervention where clinicians encourage patients to join the Asthma UK online community, then test it rigorously. If the intervention works, it could improve asthma control and quality of life at large scale within five years, at low cost. The team will run a feasibility study with 50 patients across three GP practices, followed by a definitive randomised controlled trial with 468 patients across 50 practices. Health economic modelling will determine cost-effectiveness. Findings could alter national, European, and global asthma guidance.
View original technical description
Research question Does promoting engagement in an online health community improve asthma control and quality of life? Background Of 4.3 million adults living with asthma in the UK, up to one third experience suboptimal control. Poor asthma control has major impacts: 93,000 people are hospitalised annually, with 121,000 A&E visits and 6.3 million primary care consultations/year. Asthma costs the UK £1.1bn/year. UK asthma mortality is amongst the worst in Europe. Digital social interventions are novel in healthcare and have potential to impact health on a large scale, for example, NHS Digital Facebook groups to promote cancer screening. Evidence of effectiveness is sparse and robust large-scale evaluations are needed. Online health communities (OHCs) now exist for asthma and many other long-term conditions. We have shown that accessing an online asthma OHC facilitates inhaler taking. This is mediated through a core of very active users, 'superusers' in the Asthma UK OHC, who are highly motivated lay individuals who exhibit judgment about the complexity of coping with asthma and the limits of their advice. The rapid move to online healthcare provides a timely context in which to test whether primary care can promote engagement with OHCs. Aims and Objectives Test the hypothesis that primary care can promote engagement in the Asthma UK OHC to improve asthma control and quality of life. Co-develop a structured intervention by primary care clinicians to promote engagement with the Asthma UK online community, and a questionnaire to identify and recruit study participants Co-develop the methods to evaluate the intervention Optimise safety and effectiveness of patients engagement and OHC moderation process Test feasibility and acceptability and effectiveness and cost effectiveness of the intervention Methods Co-develop with stakeholders a questionnaire survey and structured intervention, informed by social support theory (Workstream 1, WS1) Develop robust methods, including health economics modelling, through the Asthma UK Centre for Applied Research Trials Methodology Platform (WS2) Develop a set of recommendations from qualitative and network science analyses of ten years of discussion threads in the Asthma UK OHC (WS3a); and evaluate OHC moderators and users experiences (WS3b) Complete a randomised feasibility study (50 patients; 3 GP practices) (WS4) Complete a randomised controlled trial (468 patients; 50 practices) with asthma control as primary outcome (WS5) Timelines of delivery Preliminary work (WS1-3) complete by 24 months. Feasibility/acceptability study (WS4) by 36m. Definitive trial and health economic evaluation (WS5) by 60m. Anticipated impact, benefits to patient and the NHS Findings have potential to improve asthma control and QOL on a large scale within 5 years of completion. By publishing robust trial and health economic evaluation and working with policy makers and guideline development groups our findings will alter national, European and global guidance on asthma. Dissemination A dissemination programme, co-developed with the PPI group, charity representatives and our knowledge exchange lead, will tailor media and messages to audiences (patients, carers and public, NHS organisations, academia, policy-makers, government agencies) to influence health policy and delivery in the UK and globally.
Plain English summaries and category classifications on this site are generated by AI and may not perfectly reflect the original research.
Is something wrong? Let us know