Health provider perspectives of electronic medication monitoring in outpatient asthma care: a qualitative investigation using the consolidated framework for implementation research

Kan, Kristin; Shaunfield, Sara; Kanaley, Madeleine; Chadha, Avneet S.; Boon, Kathy; Morales, Luis; Davis, Matthew M.; Vojta, Deneen; Gupta, Ruchi S.

doi:10.1080/02770903.2020.1846745

Cited by 12 publications

(19 citation statements)

References 33 publications

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“…With regard to healthcare professionals, apart from e-health literacy skills, there is a need of training on EMD functioning, checking alerts, dashboards and typical errors [ 78 ]. Healthcare professionals have highlighted a high degree of administrative burden and complexity of these interventions, that would require additional employees to handle the corresponding workload [ 79 ]. Furthermore, a study showed that providing adherence information to healthcare professionals did not improve adherence unless the professional deliberately decided to check the details of a specific patient [ 69 ].…”

Section: Discussionmentioning

confidence: 99%

Clinical Impact of Electronic Monitoring Devices of Inhalers in Adults with Asthma or COPD: A Systematic Review and Meta-Analysis

et al. 2023

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We conducted a systematic review and meta-analysis to gain insight into the characteristics and clinical impact of electronic monitoring devices of inhalers (EMDs) and their clinical interventions in adult patients with asthma or COPD. The search included PubMed, Web of Science, Cochrane, Scopus and Embase databases, as well as official EMDs websites. We found eight observational studies and ten clinical trials, assessing a wide range of clinical outcomes. Results from the meta-analysis on adherence to inhalers in a period over three months were favourable in the EMD group (fixed effects model: SMD: 0.36 [0.25–0.48]; random effects model SMD: 0.41 [0.22–0.60]). An exploratory meta-analysis found an improvement in ACT score (fixed effect model SMD: 0.25 [0.11–0.39]; random effects model: SMD: 0.47 [−0.14–1.08]). Other clinical outcomes showed mixed results in the descriptive analyses. The findings of this review highlight the benefits of EMDs in the optimization of adherence to inhaled therapy as well as the potential interest in other clinical outcomes.

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Section: Discussionmentioning

confidence: 99%

Clinical Impact of Electronic Monitoring Devices of Inhalers in Adults with Asthma or COPD: A Systematic Review and Meta-Analysis

et al. 2023

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“…Thus, overall, parents in our study found the intervention acceptable and generally favorable. However, parents also emphasized key improvements for the future design and development of this multicomponent, complex health intervention utilizing EMM [ 26 , 27 ].…”

Section: Discussionmentioning

confidence: 99%

Parent Experiences With Electronic Medication Monitoring in Pediatric Asthma Management: Qualitative Study

Kan¹,

Shaunfield²,

Kanaley³

et al. 2021

JMIR Pediatr Parent

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Background Electronic medication monitoring (EMM) is a digital tool that can be used for tracking daily medication use. Previous studies of EMM in asthma management have been conducted in adults or have examined pediatric interventions that use EMM for less than 1 year. To understand how to improve EMM-enhanced interventions, it is necessary to explore the experiences of parents of children with asthma, recruited from outpatient practices, who completed a 12-month intervention trial. Objective The objective of our study was to use qualitative inquiry to answer the following questions: (1) how did using an EMM-enhanced intervention change parents'/caregivers’ experiences of managing their child’s asthma, and (2) what do parents recommend for improving the intervention in the future? Methods Parents were recruited from the intervention arm of a multicomponent health intervention enhanced by Bluetooth-enabled sensors placed on inhaler medications. Semistructured interviews were conducted with 20 parents of children aged 4-12 years with asthma. Interviews were audio-recorded, transcribed, and inductively analyzed using a constant comparative approach. Results Interview participants reflected an even mix of publicly and privately insured children and a diverse racial-ethnic demographic. Parents discussed 6 key themes related to their experience with the EMM-enhanced intervention for the management of their child's asthma: (1) compatibility with the family's lifestyle, (2) impact on asthma management, (3) impact on the child’s health, (4) emotional impact of the intervention, (5) child’s engagement in asthma management with the intervention, and (6) recommendations for future intervention design. Overall, parents reported that the 12-month EMM intervention was compatible with their daily lives, positively influenced their preventive and acute asthma management, and promoted their child's engagement in their own asthma management. While parents found the intervention acceptable and generally favorable, some parents identified compatibility issues for families with multiple caregivers and frustration when the technology malfunctioned. Conclusions Parents generally viewed the intervention as a positive influence on the management of their child's asthma. However, our study also highlighted technology challenges related to having multiple caregivers, which will need to be addressed in future iterations for families. Attention must be paid to the needs of parents from low socioeconomic households, who may have more limited access to reliable internet or depend on other relatives for childcare. Understanding these family factors will help refine how a digital tool can be adopted into daily disease management of pediatric asthma.

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“… 78 Similarly, in asthma care, Kan et al reported concerns from healthcare providers regarding the anticipated additional workload that is likely to accompany the use of digital device data in routine practice, and that extra employees would be required to manage this increase. 79 …”

Section: Where To From Here?mentioning

confidence: 99%

“… 78 , 82 The integration of data into electronic medical records would likely also improve the efficiency of associated medical appointments for both patients and clinicians alike. 79 , 82 Thus, digital solutions have great potential to offer advanced and targeted care should a consensus framework for implementation be established.…”

Section: Where To From Here?mentioning

confidence: 99%

Advancing Digital Solutions to Overcome Longstanding Barriers in Asthma and COPD Management

Bosnic‐Anticevich¹,

Bakerly²,

Chrystyn³

et al. 2023

PPA

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Maintenance therapy delivered via inhaler is central to asthma and chronic obstructive pulmonary disease (COPD) management. Poor adherence to inhaled medication and errors in inhalation technique have long represented major barriers to the optimal management of these chronic conditions. Technological innovations may provide a means of overcoming these barriers. This narrative review examines ongoing advances in digital technologies relevant to asthma and COPD with the potential to inform clinical decision-making and improve patient care. Digital inhaler devices linked to mobile apps can help bring about changes in patients’ behaviors and attitudes towards disease management, particularly when they build in elements of interactivity and gamification. They can also support ongoing technique education, empowering patients and helping providers maximize the value of consultations and develop effective action plans informed by insights into the patient’s inhaler use patterns and their respiratory health. When combined with innovative techniques such as machine learning, digital devices have the potential to predict exacerbations and prompt pre-emptive intervention. Finally, digital devices may support an advanced precision medicine approach to respiratory disease management and help support shared decision-making. Further work is needed to increase uptake of digital devices and integrate their use into care pathways before their full potential in personalized asthma and COPD management can be realized.

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Health provider perspectives of electronic medication monitoring in outpatient asthma care: a qualitative investigation using the consolidated framework for implementation research

Cited by 12 publications

References 33 publications

Clinical Impact of Electronic Monitoring Devices of Inhalers in Adults with Asthma or COPD: A Systematic Review and Meta-Analysis

Clinical Impact of Electronic Monitoring Devices of Inhalers in Adults with Asthma or COPD: A Systematic Review and Meta-Analysis

Parent Experiences With Electronic Medication Monitoring in Pediatric Asthma Management: Qualitative Study

Advancing Digital Solutions to Overcome Longstanding Barriers in Asthma and COPD Management

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