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Randomized Controlled Trial
. 2013 Sep-Oct;1(5):485-93.
doi: 10.1016/j.jaip.2013.06.010. Epub 2013 Aug 30.

The impact of peer support and mp3 messaging on adherence to inhaled corticosteroids in minority adolescents with asthma: a randomized, controlled trial

Giselle Mosnaim  1 , Hong Li  2 , Molly Martin  2 , DeJuran Richardson  3 , Paula Jo Belice  2 , Elizabeth Avery  2 , Norman Ryan  4 , Bruce Bender  5 , Lynda Powell  2
Affiliations
Randomized Controlled Trial

The impact of peer support and mp3 messaging on adherence to inhaled corticosteroids in minority adolescents with asthma: a randomized, controlled trial

Giselle Mosnaim et al. J Allergy Clin Immunol Pract. 2013 Sep-Oct.

Abstract

Background: Poor adherence to inhaled corticosteroids (ICS) is a critical risk factor contributing to asthma morbidity among low-income minority adolescents.

Objective: This trial tested whether peer support group meetings and peer asthma messages delivered via mp3 players improved adherence to ICS.

Methods: Low-income African American and/or Hispanic adolescents, ages 11-16 years old, with persistent asthma, and poor (≤ 48%) adherence to prescription ICS during the 3-week run-in were randomized to intervention or attention control groups (ATG) for the 10-week treatment. During treatment, the intervention arm subjects participated in weekly coping peer group support sessions and received mp3 peer-recorded asthma messages that promoted adherence. The ATG participated in weekly meetings with a research assistant and received an equivalent number of mp3 physician-recorded asthma messages. Adherence was measured by using self-report and the Doser CT, an electronic dose counter. The primary outcome was the difference in adherence at 10 weeks between the 2 arms.

Results: Thirty-four subjects were randomized to each arm. At 10 weeks, no statistical difference in objectively measured adherence could be detected between the 2 arms when adjusting for baseline adherence (P = .929). Adherence declined in both groups over the course of the active treatment period. In both study arms, self-reported adherence by participants was significantly higher than their objectively measured adherence at week 10 (P < .0001).

Conclusion: Improving medication adherence in longitudinal studies is challenging. Peer support and mp3-delivered peer asthma messages may not be of sufficient dose to improve outcomes.

Keywords: Adolescents; Asthma knowledge; Childhood asthma; Health status disparities; Inner city; Medication adherence; Outcome assessment (health care).

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Figures

Figure 1
Figure 1. CONSORT Diagram
The CONSORT flow diagram illustrates the flow of participants from eligibility to completion of treatment.
Figure 2
Figure 2. Study Timeline
The study timeline illustrates the run-in, pre-active treatment, and active treatment phases. Data collection occurred at weeks 5 and 10 of the active treatment phase.
See this image and copyright information in PMC

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