Electronic Reminder Improved Asthma Medication Adherence

Amy Chan   BPharm(Hons) RegPharmNZ  MPS  ANZCP Pharmacist / PhD candidate Department of Paediatrics Auckland Hospital Faculty of Medical & Health Sciences University of Auckland  Auckland, New ZealandMedicalResearch.com Interview with:
Amy Chan  
BPharm(Hons) RegPharmNZ  MPS  ANZCP
Pharmacist / PhD candidate
Department of Paediatrics Auckland Hospital
Faculty of Medical & Health Sciences
University of Auckland  Auckland, New Zealand

Medical Research: What is the background for this study? What are the main findings?

Response: Asthma is one of the most common childhood conditions, affecting 1 in 4 children in New Zealand.  Although there are many effective medications available for asthma, of which the most important are inhaled corticosteroids, asthma control remains suboptimal due to poor adherence.  In children, adherence to regular preventive asthma therapy is about 50%, and can be as low as 30%.  Our randomised controlled trial looked at use of an electronic monitoring device with an in-built audiovisual reminder to see if it improved adherence and asthma control.  We recruited 220 children aged between 6-15yrs, who presented to the emergency department with asthma and randomised them to receive the device either with the audiovisual function enabled or disabled.  It found that those who received the audiovisual reminder (the intervention arm) took a median of 84% of their inhaled corticosteroids compared to just 30% in those who did not receive the reminder (control arm).  This equates to a 180% improvement in adherence.  We found significant improvements also in asthma control (including reduced asthma symptoms and increased participation in daily activities) and a reduction in reliever use from 17.4% to 9.5% in those who received the reminder.

Medical Research: What should clinicians and patients take away from your report?

Response: This is the first randomised controlled trial to show that a reminder intervention can improved adherence and asthma control in children and adolescents with asthma.  It suggests that use of an electronic device with an in-built audiovisual reminder can improve medication adherence (and correspondingly asthma control) in children with asthma, particularly those with poor adherence (such as those who present to the emergency departments with asthma, and in whom non-adherence is primarily related to forgetfulness).

Medical Research: What recommendations do you have for future research as a result of this study?

Response: This study has shown the benefits of a reminder intervention in a particular group of children who present to the emergency department with asthma, in a 6-month trial.  It would be useful to see if the benefits of this intervention are sustained beyond 6-months, and whether it is useful in those with present to primary care (such as general physicians).  The effects of varying reminder frequency on adherence and asthma outcomes would also be of interest to minimise reminder fatigue and perhaps improve the long-term sustainability of this intervention.

Citation:

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
Amy H Y Chan BPharm,Alistair W Stewart BSc,Jeff Harrison PhD,Prof Carlos A Camargo MD,Prof Peter N Black FRACP,Prof Edwin A Mitchell FRSNZ
The Lancet Respiratory Medicine – 21 January 2015
DOI: 10.1016/S2213-2600(15)00008-9

 

MedicalResearch.com Interview with:, Amy Chan, BPharm(Hons) RegPharmNZ MPS ANZCP, & Pharmacist / PhD candidate (2015). Electronic Reminder Improved Asthma Medication Adherence MedicalResearch.com

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