Digital interventions to improve adherence to maintenance medication in asthma

Abstract

Farmer 1999 Farmer KC. Methods for measuring and monitoring medication regimen adherence in clinical trials and clinical practice.

Digital interventions to improve adherence to maintenance medication in asthma

“…Digital tools may support treatment adherence; however, there are limitations. For example, Electronic Monitoring devices (EMDs) can be used with inhalation devices and pill bottles to record doses dispensed, 5 but they cannot ensure correct inhalation technique or actual medication‐taking 3,6 . Several Novel EMDs, for example Hailie‐Smart‐Inhaler, are in development to assess both inhalation and actuation 7 …”

“…EMDs were found to be the most effective digital intervention for improving adherence, followed by SMS messages (Figure 1). The website‐based interventions had no significant effect on adherence but interestingly noted to be the most effective in improving asthma control as assessed by standardised patient questionnaires, followed by SMS messages 5 . A broad range of digital interventions have been considered here, and this sub‐group analysis is important when deciding what to recommend in clinic.…”

“…Effects of digital intervention versus usual care on asthma treatment adherence, stratified by type of digital intervention 5 . Data show the percentage adherence in trial participants randomised to a digital intervention versus usual care, and are reproduced with permission from Cochrane review ‘Digital interventions to improve adherence to maintenance medication in asthma’ 5 …”

“…There is some suggestion in the review that interventions with an in‐person component (i.e. a healthcare professional or a trained peer involved in the intervention either at the point of introduction of the digital intervention or on an ongoing basis), 5 had a greater effect on adherence than digital interventions alone, suggesting support offered by healthcare services can potentially potentiate the effect of the intervention. The analysis also suggests that providing adherence feedback to the subjects increases the effect on asthma symptom control.…”

Medication nonadherence: health impact, prevalence, correlates and interventions

“…Many interventions have been designed to support adherent behaviour across a range of conditions and treatments with varying degrees of efficacy (e.g. Chan et al, 2018;Conn & Ruppar, 2017;Horne, 1998;Kripalani et al, 2007;MacDonald et al, 2016;Nieuwlaat et al, 2014;Pearce et al, 2022). One systematic review found that only 16 out of 37 trials reported an improvement in adherence across chronic conditions, and suggested that interventions involving monitoring and feedback, or reducing dosing demands were most likely to be effective (Kripalani et al, 2007).…”