Title: Mobile health intervention increases inhaled corticosteroid adherence in adolescents with asthma
Speaker: Richelle Kosse
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Adherence rates among asthma patients are generally low, resulting in poorly controlled asthma. Adherence decreases even more during adolescence. We developed (in co-creation with patients) an interactive mobile health (mHealth) intervention; the ADolescent Adherence Patient Tool (ADAPT) containing different elements, such as questionnaires to monitor symptoms, medication alarm, educational movies, peer chat, and healthcare provider chat.
Objectives      Â
To evaluate the effect of the ADAPT intervention on inhaled corticosteroid adherence and asthma control in adolescents (12-18 year).
Methods
We conducted a cluster randomized controlled trial in 66 community pharmacies. Self-reported adherence (Medication Adherence Report Scale (MARS)), asthma control (Control of Allergic Rhinitis and Asthma Test (CARAT)), and asthma related quality of life were measured at start (t=0) and end of follow-up (t=6). We used mixed effect models to analyse the effect.
Results
In total, 234 adolescents (147 in the control and 87 in the intervention group) completed the study (mean age 15.1±1.9 years; 52.6% females). Adherence rates of patients with low baseline adherence (N=76; MARS ≤19) increased with 1.42 points in the intervention group (N=26), whereas the rates of patients in the control group (N=50) decreased with 0.70 (intervention effect +2.12, P=0.04). This effect was larger (+2.52, P=0.02) in patients with uncontrolled asthma (CARAT ≤24) having low adherence rates (MARS ≤20). No effect was observed on asthma control or asthma related quality of life.
Conclusions
The ADAPT intervention increases adherence in adolescent asthma patients with poor adherence. Healthcare providers should consider a personalized mHealth approach to improve adherence in adolescents with asthma.