Evaluation of a mobile health intervention to support asthma self-management and adherence in the pharmacy

Abstract

Background Several effective mobile health (mHealth) interventions have been developed to support patients with their medication use, however hardly any is implemented in clinical practice. Process evaluations and user experiences are therefore important for further implementation. Objective To explore experiences, barriers, and facilitators of pharmacists and patients towards the use of the interactive ADolescent Adherence Patient Tool (ADAPT). In addition, the perceptions of pharmacists towards mHealth interventions in general were explored. Setting Dutch community pharmacies. Methods Pharmacists (N = 24) and adolescent asthma patients (N = 87; age 12–18) completed a questionnaire about the ADAPT intervention. Pharmacists who did not have access to the ADAPT intervention (N = 26) completed a questionnaire on their perceptions towards mHealth. Main outcome measure Experiences, barriers, and facilitators of pharmacists and patients. Results Most patients (78%) would recommend the ADAPT intervention to others, and thought that the pharmacy was the right place for mHealth aiming to support adherence (63%). The possibility to monitor asthma symptoms was highly appreciated by patients and pharmacists. Pharmacists were satisfied with ADAPT intervention (96%), and using the intervention was not time consuming (91%). The ADAPT intervention promoted contact with patients (74%) and facilitated the healthcare providing role of pharmacists (83%). Pharmacists who did not have access to the ADAPT intervention mentioned time constraints and funding as main barriers for using mHealth. Conclusion Pharmacists and patients perceived many beneficial effects and were positive about the the use of the interactive ADolescent Adherence Patient Tool (ADAPT) intervention. This study emphasizes opportunities for mHealth in improving the quality of care, which supports the need for further implementation in clinical practice. Electronic supplementary material The online version of this article (10.1007/s11096-019-00798-3) contains supplementary material, which is available to authorized users.

Digital technologies for monitoring and improving treatment adherence in children and adolescents with asthma: A scoping review of randomised controlled trials

“…They were included in the analysis, using whatever data was provided; two of the abstracts only presented interim results [26,27]. Four studies were analysed by nine separate articles and abstracts: the ADolescent Adherence Patient Tool (ADAPT) study [25,33,34], a study comparing web-ACT and FENO monitoring with standard care [35,36], a study of inhaler electronic monitoring devices (EMDs) with audiovisual reminders [37,38], and a study of a real-time medication monitoring (RTMM) device with SMS reminders [28,39].…”

“…There was a wide range in study durations, from 3 weeks [40] to 24 months [41], with the most common length of follow-up being 6 or 12 months (n=4 [25,31,33,34,37,38,42] and n=3 studies [27,28,35,36,39] for each). There was also a large variety of numbers of participants included in the 15 studies, ranging from 22 [30] to almost 1200 [41], with an average of approximately 230 participants and a median of 209 [28,39].…”

“…4 studies took place across multiple centres [26,28,32,35,36,39], and most of the rest were associated with large medical centres [40][41][42][43] or clinics [27,31]. The remaining 5 studies recruited from or were associated with a hospital emergency department [37,38], community pharmacies [25,33,34], Howard University [29], and impoverished, rural school districts [44]. One study did not specify the healthcare setting of the study [30].…”

“…Pharmacists involved in the intervention reported valuing the improved contact with patients and found the intervention satisfactory, useful in fulfilling their role, and not time-consuming [34]. This was in contrast to the perceptions of pharmacists who did not participate in the intervention, who identified time constraints as a barrier to the use of mHealth [34]. However, a barrier was identified because the ADAPT app's 'stand-alone' desktop interface for pharmacists was not integrated with the pharmacy's general information system [34].…”

Mold exposure levels in northeastern U.S. schools and homes : a quantitative examination of the difference in mold exposure levels between schools and homes & the asthma prevalence for a subset of northeastern U.S. schools among children ages 4 to 15

“…Better self-efficacy with medication adherence and controlling asthma symptoms has been shown to improve quality of life (Kosse, Bouvy, de Vries, & Koster, 2019;Rhee, Belyea, Hunt, & Brasch, 2011;Rhee, Love, Harrington, & Walters, 2020). One technique shown to reduce anxiety, improve asthma control, and increase quality of life is breathing retraining (Bignall, Luberto, Cornette, Haj-Hamed, & Cotton, 2015).…”