E-health and consultation rates for respiratory illnesses in infants: A randomised clinical trial in primary care

Abstract

Background: It is assumed that clear and complete information on the internet can reduce healthcare consumption. Aim: We assessed in a randomised clinical trial whether a personalised online parent information program on infant respiratory symptoms can reduce primary care utilisation. Design and setting: Randomised clinical trial in primary healthcare centres in a new residential area in the Netherlands. Method: A web-based program (WHISTLER-online) was developed for parents that offered general information on childhood respiratory disease and personalised risk assessments. Parents of infants who enrolled from June 2009 to June 2012 in WHISTLER, an ongoing population-based birth cohort, were randomly allocated to 'WHISTLER-online' or 'usual care'. Information about, first, consultations and, second, associated prescriptions for respiratory symptoms during the first year of life was collected from the electronic patient files. Results: A total of 323 infants were randomly assigned to WHISTLER-online and 322 to usual care, and 314 and 305, respectively, were analysed. Of the parents, 70% used WHISTLER-online, and 99% of them judged it to be clear and useful information. There were differences neither in consultation rates for respiratory symptoms (incidence rate ratio 0.96 [95% CI = 0.85 to 1.09, P = 0.532]) nor in associated drug prescriptions. Conclusion: Although parents greatly appreciate the provided facilities, a personalised e-support program on respiratory illnesses in infants does not substantially reduce healthcare utilisation.