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

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://ichgcp.net/clinical-trials-registry/NCT03277664.

Keywords: Adherence; Asthma; Children; Electronic device.

Conflict of interest statement

Competing interestsThe authors declare that they have no competing interests.

© The Author(s) 2020.

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

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Source: PubMed

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