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. 2020 Jul 29:16:68.
doi: 10.1186/s13223-020-00466-6. eCollection 2020.

The effect of electronic monitoring combined with weekly feedback and reminders on adherence to inhaled corticosteroids in infants and younger children with asthma: a randomized controlled trial

Jiande Chen #  1 , Juan Xu #  1 , Liebin Zhao #  1 , Jing Zhang  1 , Yong Yin  1 , Fen Zhang  1
Affiliations

The effect of electronic monitoring combined with weekly feedback and reminders on adherence to inhaled corticosteroids in infants and younger children with asthma: a randomized controlled trial

Jiande Chen et al. Allergy Asthma Clin Immunol. .

Abstract

Background: Adherence to asthma treatment among children is usually poor. We sought to explore whether electronic adherence monitoring combined with weekly feedback regarding adherence along with a reminder to use inhaled corticosteroids (ICS) would lead to improved compliance with ICS in infants and younger children with asthma.

Methods: 96 recruited children (aged 6 months to 3 years) with mild or moderate persistent asthma who were on regular inhaled corticosteroids were randomly allocated to receive electronic monitoring combined with instant messaging software (IMS)-based weekly feedback regarding adherence along with a reminder to keep taking the ICS (intervention group) and to receive electronic monitoring only (control group).

Results: The mean device-monitored adherence was significantly higher in the intervention group (80%) than in the control group (45.9%), with a difference of 34.0% (95% confidence interval [CI], 26.8-41.3%; P < 0.001). No difference in the mean caregiver-reported adherence between the interventional group (89.7%) and the control group (92.7%) was observed (P = 0.452).

Conclusions: Electronic monitoring combined with IMS-based weekly feedback regarding adherence along with a reminder to keep taking the ICS significantly improved the treatment compliance of infants and younger children with asthma. Caregiver-reported adherence is an unreliable monitoring indicator.Trial registration ClinicalTrials.gov, NCT03277664. Registered 11 September 2017-Retrospectively registered, https://clinicaltrials.gov/ct2/results?cond=&term=NCT03277664.

Keywords: Adherence; Asthma; Children; Electronic device.

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Conflict of interest statement

Competing interestsThe authors declare that they have no competing interests.

Figures

Fig. 1
Fig. 1
Flow diagram showing progress of participants through trial
Fig. 2
Fig. 2
a Smart Track Device (white) attached to a nebulizer. The device electronically recorded the date/time of every actuation and automatically sent the usage data to central server via Bluetooth. b Example of adherence report from App. The graph shows the number of nebulized medication the patient took each day
Fig. 3
Fig. 3
Impact of different interventions and follow-up time on device-monitored adherence
See this image and copyright information in PMC

References

    1. Jentzsch NS, Camargos P, Sarinho ES, Bousquet J. Adherence rate to beclomethasone dipropionate and the level of asthma control. Respir Med. 2012;106(3):338–343. doi: 10.1016/j.rmed.2011.12.001. - DOI - PubMed
    1. Duncan CL, Hogan MB, Tien KJ, Graves MM, Chorney JM, Zettler MD, Koven L, Wilson NW, Dinakar C, Portnoy J. Efficacy of a parent-youth teamwork intervention to promote adherence in pediatric asthma. J Pediatr Psychol. 2013;38(6):617–628. doi: 10.1093/jpepsy/jss123. - DOI - PMC - PubMed
    1. Bender B, Zhang L. Negative affect, medication adherence, and asthma control in children. J Allergy Clin Immunol. 2008;122(3):490–495. doi: 10.1016/j.jaci.2008.05.041. - DOI - PubMed
    1. Milgrom H, Bender B, Ackerson L, Bowry P, Smith B, Rand C. Noncompliance and treatment failure in children with asthma. J Allergy Clin Immunol. 1996;98(6 Pt 1):1051–1057. doi: 10.1016/S0091-6749(96)80190-4. - DOI - PubMed
    1. Williams LK, Peterson EL, Wells K, Ahmedani BK, Kumar R, Burchard EG, Chowdhry VK, Favro D, Lanfear DE, Pladevall M. Quantifying the proportion of severe asthma exacerbations attributable to inhaled corticosteroid nonadherence. J Allergy Clin Immunol. 2011;128(6):1185–1191.e1182. doi: 10.1016/j.jaci.2011.09.011. - DOI - PMC - PubMed

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