The effect of an electronic monitoring device with audiovisual reminder function on adherence to inhaled corticosteroids and school attendance in children with asthma: a randomised controlled trial

Chan, Amy Hai Yan; Stewart, Alistair; Harrison, Jeff; Camargo, Carlos A.; Black, Peter; Mitchell, Edwin A.

doi:10.1016/s2213-2600(15)00008-9

Cited by 216 publications

(254 citation statements)

References 54 publications

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“…Finally, some patients have difficulty in being adherent due to difficulties using the device, or because of a regimen with multiple inhalers is overwhelming [13]. Patients with intentional non-adherence due to side effects may need an empathic discussion about the pros and cons of their treatment [36], whereas patients with non-intentional adherence due to forgetfulness may need a more feasible regimen such as once-daily dosing [100], and inhaler reminders [101,102]. …”

Section: Management Of Severe Asthmamentioning

confidence: 99%

Nordic consensus statement on the systematic assessment and management of possible severe asthma in adults

Porsbjerg

Ulrik

Skjold

et al. 2018

European Clinical Respiratory Journal

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Although a minority of asthma patients suffer from severe asthma, they represent a major clinical challenge in terms of poor symptom control despite high-dose treatment, risk of exacerbations, and side effects. Novel biological treatments may benefit patients with severe asthma, but are expensive, and are only effective in appropriately targeted patients. In some patients, symptoms are driven by other factors than asthma, and all patients with suspected severe asthma (‘difficult asthma’) should undergo systematic assessment, in order to differentiate between true severe asthma, and ‘difficult-to-treat’ patients, in whom poor control is related to factors such as poor adherence or co-morbidities. The Nordic Consensus Statement on severe asthma was developed by the Nordic Severe Asthma Network, consisting of members from Norway, Sweden, Finland, Denmark, Iceland and Estonia, including representatives from the respective national respiratory scientific societies with the aim to provide an overview and recommendations regarding the diagnosis, systematic assessment and management of severe asthma. Furthermore, the Consensus Statement proposes recommendations for the organization of severe asthma management in primary, secondary, and tertiary care.

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Section: Management Of Severe Asthmamentioning

confidence: 99%

Nordic consensus statement on the systematic assessment and management of possible severe asthma in adults

Porsbjerg

Ulrik

Skjold

et al. 2018

European Clinical Respiratory Journal

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“…There is a trend towards few inhaler technique errors [88,89] and patient satisfaction favoring the newer devices, however, real-life, long-term data are not as yet available, and there is a call for well-designed studies in the future [90]. Until that time, training patients in all the steps required to use these newer inhaler devices is recommended [3].What is particularly exciting is the possibilities enabled by inhaler devices with e-connectivity [41,91], i.e., devices which include microprocessors allowing for real-time adherence (by date and time stamping actual use) and inhaler technique monitoring.Emerging into research and practice are a range of built-in or add-on devices, enabling the monitoring of adherence (through date and time stamping dose delivery) [92][93][94] and the monitoring of inhaler technique with and without feedback, in real time [92,95,96]. For example, the SmartTrack device, which can be attached to a pMDI, delivers reminders for dose administration through customized ringtones [97,98].…”

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confidence: 99%

Identifying Critical Errors: Addressing Inhaler Technique in the Context of Asthma Management

et al. 2018

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Medication use has always played a highly significant role in the overall management of asthma, with appropriate use being linked to good asthma control. However, while patients with asthma enjoy the 'luxury' of having medications delivered directly to the lungs via inhaler devices, with that comes the additional challenge of ensuring that inhaler devices are used correctly. Research and practice provides evidence to the challenges associated with inhaler use and the particular steps that patients perform incorrectly. While this problem is well documented, acknowledged and reported, little has changed in 40 years, and the proportion of patients using inhaler devices remains unacceptably high. This review focuses on aspects specific to the errors that patient's make, the significance of these errors, and the important considerations for health care practitioners in supporting patients in correctly using their inhalers. This review highlights the complexities associated with patient's making inhaler technique errors and highlights the opportunities that lie in future technological developments of inhaler devices. Now more than ever, in the era of precision medicine, it is important that we address inhaler technique use once and for all.Keywords: Asthma control; Critical errors; Health behavior; Health care practitioners; Inhaler devices; Maintenance; Mastery; Skills THE IMPORTANCE OF MEDICATION USE IN OUR UNDERSTANDING OF RESPIRATORY DISEASEAfter decades of research, practice, and perceived knowledge, we find ourselves at crossroads in our understanding and management of airway diseases, such as asthma [1]. While asthma is an obstructive airways disease, which Pulm Ther (2018) 4:1-12 https://doi.org/10.1007/s41030-018-0051-0 to our current knowledge can neither be prevented nor cured, it is a disease that fluctuates in severity and 'control', is exacerbated by varying triggers, and its course over an individual's lifetime is essentially unpredictable [1]. While the conversation about asthma and airways disease more broadly is not the focus of this review, it becomes particularly relevant in our consideration of the use of medications. It is critical, now more than ever, that we understand the role of medication use, as it can provide us with further understanding about respiratory disease more broadly [2]. Given that asthma management is reliant on the use of medications [3], ensuring that patients use their medications correctly has become more than just a practical matter; it is a complex and critical issue. Correct medication use has become a fundamental step in our exploration and understanding of disease traits [1,2]: with careful and more precise evaluation of patient's response to treatment becoming integral to our understanding of disease endotypes and our evolution towards precision medicine [1,2]. For this reason, if for no other, it is now more important than ever that we address inhaler use, especially our knowledge of critical errors, which can 'cloud' our understanding of treatment success. T...

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“…Adherence to the controller medication (ICS) regimen was calculated daily in 12 hour increments (12:00 am -11:59 am and 12:00 pm to 11:59 pm) as the number of doses prescribed compared to the number taken over 12 hours to avoid the impact of medication overdosing and dumping. [26,27] Study group adherence was calculated by averaging daily adherence. Duplicative data (from BT cap and manual entry) were excluded at the time of data analysis, if the device subsequently paired with the smartphone and transferred data.…”

Section: Changes To Mhealth Platform Through Iterative Designmentioning

confidence: 99%

Feasibility of Smartphones for Real-time Assessment of Adherence Behavior and Symptom Exacerbation for High Risk Youth and Adolescents with Asthma: A Pilot Study (Preprint)

Teufel¹,

Patel²,

Shuler³

et al. 2018

JMIR mHealth and uHealth

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Background: Youth with asthma who have poor medication adherence, limited access to care, and are frequently seen in the acute care setting are often termed "high risk." Objective: Our purpose was to design and test the feasibility of using smartphone technology to assess contextual factors that may impact changes in daily medication adherence and identify new symptom episodes among high risk youth with asthma in their home environment. Methods: Youth 8-17 years with high risk asthma from two children's hospitals were eligible for the 2-month study. An App was downloaded on participants' phones at enrollment. Daily text reminders were sent to complete ecological momentary assessment of asthma symptoms and other contextual factors such as emotional state using the App. Bluetooth inhaler devices were used to record timestamps of inhaler use with the ability to review and manually enter data. Acceptability was assessed with surveys, key informant

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The effect of an electronic monitoring device with audiovisual reminder function on adherence to inhaled corticosteroids and school attendance in children with asthma: a randomised controlled trial

Cited by 216 publications

References 54 publications

Nordic consensus statement on the systematic assessment and management of possible severe asthma in adults

Nordic consensus statement on the systematic assessment and management of possible severe asthma in adults

Identifying Critical Errors: Addressing Inhaler Technique in the Context of Asthma Management

Feasibility of Smartphones for Real-time Assessment of Adherence Behavior and Symptom Exacerbation for High Risk Youth and Adolescents with Asthma: A Pilot Study (Preprint)

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