The purpose of this study is to improve patient's quality of life in a cost-effective way by a self-management programme guided by doctors and a specialist asthma nurse through information and communication technology (ICT). The safety and cost-effectiveness of asthma self-management education as such has been fully established nationally and internationally. In addition, there is increasing evidence that ICT can play a role in order to deliver components of these programmes in primary and secondary care. However, the current study is the first project in patients with asthma that integrates all 4 components of self-management education: information, self-monitoring, regular medical review and a written action plan. It is the first study that evaluates the cost-effectiveness of support by innovative information and communication technology. SMASHING consists of 2 trials: one in adults (18-50) and one in adolescents (13-17 years). Plan of investigation Design A randomised parallel trial with 2 arms and 1 year follow-up in 2 phases in order to compare ICT-supported care with usual care. The first phase serves as a baseline period and is solely aimed at collecting data on asthma control and behaviour and lifestyle, and predisposing, reinforcing and enabling factors. The second phase includes the intervention and evaluation period. Study Population Patients with mild to moderate persistent asthma will be identified via the LUMC general practice network and hospital information systems. Patients need have access to a computer with an internet-connection and are able to communicate in the Dutch language. Intervention The current intervention is additional to usual care and includes monitoring of symptoms and lung function and communication of results, feedback and reminders via internet and short message services on telephones. The service is supervised by a specialised nurse and facilitates discussion groups, a chat box and consultation via private messaging. Asthma self-management education and training sessions are given by a specialist nurse. Outcome measures The primary and secondary outcome are health related quality of life (AQLQ) and asthma control (ACQ), respectively. Awards SMASHING has won the Spider Award 2006. Read the jury report here (in Dutch) and the interview on the website of the Astma Foundation.