A Prospective, Randomized, Controlled Study of Inhaler Electronic Monitoring Devices to Improve Adherence in Children with Asthma

Simoneau, Tregony; Sun, Ye; Gherlone, Nicole; Almeida, Sigrid; Manice, Melissa; Hollenbach, Jessica P.

doi:10.1164/ajrccm-conference.2019.199.1_meetingabstracts.a7177

Cited by 4 publications

(16 citation statements)

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“…Despite these restrictions to the scope of the review, the included studies had a wide variety of study durations, sample sizes, age ranges, and types of digital intervention. Over a third of the references identified as eligible during title and abstract screening only had abstracts available (7/20) [26][27][28][29][30][31][32]. They were included in the analysis, using whatever data was provided; two of the abstracts only presented interim results [26,27].…”

Section: Study Characteristicsmentioning

confidence: 99%

“…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].…”

Section: Study Characteristicsmentioning

confidence: 99%

“…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].…”

Section: Study Characteristicsmentioning

confidence: 99%

“…9 studies evaluated the effectiveness of their intervention at improving treatment or medication adherence. Two thirds (6/9) reported significantly higher adherence in the intervention group compared to the control group [25,28,31,37,[39][40][41]. Of the remaining three studies, two reported higher adherence in the intervention group compared to the control group, but no analysis of significance was provided [27,44].…”

Section: Treatment or Medication Adherencementioning

confidence: 99%

“…Most of the studies included in the review (9/15, or 11 of the 20 articles) did not explicitly discuss how the digital intervention they were evaluating was integrated with clinical care pathways [27][28][29][30][31][37][38][39][40]42,43]. There were few studies that described sending data from the interventions back to physicians to update the patients' health records or inform care, although this potential would likely be feasible for many of them.…”

Section: Integration With Clinical Care Pathwaysmentioning

confidence: 99%

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

Milne‐Ives

Meinert

2021

Preprint

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Background: Inadequate paediatric asthma care has resulted in potentially avoidable unplanned hospital admissions and morbidity. A wide variety of digital technologies have been developed to help monitor and support treatment adherence for children and adolescents with asthma. However, existing reviews need to be updated and expanded to provide an overview of the current state of research around these technologies and how they are being integrated into existing healthcare services and care pathways. Objective: The purpose of this scoping review is to provide an overview of the current research landscape and knowledge gaps regarding the use of digital technologies to support the care of children and adolescents with asthma. Methods: The review was structured according to the Preferred Reporting Items for Systematic Reviews and Meta-Analyses extension for Scoping Reviews (PRISMA-ScR) and Population, Intervention, Comparator, Outcome, and Study (PICOS) frameworks. Five databases (PubMed, the Cochrane Central Register of Controlled Trials (CENTRAL), Web of Science, EMBASE, and PsycINFO) were systematically searched for studies published in English from 2014 on. One reviewer screened references, selected studies for inclusion based on the eligibility criteria, and extracted the data, which were synthesised in a descriptive analysis. Results: A wide variety in study characteristics - including the number and age of participants, study duration, and type of digital intervention - was identified. There was mixed evidence for the effectiveness of the interventions; 6 of the 9 studies that evaluated treatment adherence found improvements, but the evidence was inconsistent for asthma control (4/9 found no evidence of effectiveness, and only one found significant evidence) and health outcome variables (4/7 found no evidence of effectiveness). The 5 studies that examined patient perceptions and assessments of acceptability and usability had generally positive findings. Conclusions: Despite the range of different digital interventions being developed to support the monitoring and treatment adherence of children and adolescents with asthma, there is limited evidence to suggest that they achieve their range of intended outcomes. Stronger evidence of their effectiveness at achieving their specific aims is needed, as this will support decisions and research about their cost-effectiveness and how these technologies can best integrate with existing clinical care pathways. This research is necessary to determine which interventions are worth supporting and adopting in the clinical care pathways.

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Section: Study Characteristicsmentioning

confidence: 99%

Section: Study Characteristicsmentioning

confidence: 99%

Section: Study Characteristicsmentioning

confidence: 99%

Section: Treatment or Medication Adherencementioning

confidence: 99%

Section: Integration With Clinical Care Pathwaysmentioning

confidence: 99%

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

Milne‐Ives

Meinert

2021

Preprint

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Digital Technologies for Monitoring and Improving Treatment Adherence in Children and Adolescents With Asthma: Scoping Review of Randomized Controlled Trials

Milne‐Ives¹,

Lam²,

Meinert³

2021

JMIR Pediatr Parent

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Background Inadequate pediatric asthma care has resulted in potentially avoidable unplanned hospital admissions and morbidity. A wide variety of digital technologies have been developed to monitor and support treatment adherence in children and adolescents with asthma. However, existing reviews need to be updated and expanded to provide an overview of the current state of research on these technologies and how they are being integrated into existing health care services and care pathways. Objective This study aims to provide an overview of the current research landscape and knowledge gaps regarding the use of digital technologies to support the care of children and adolescents with asthma. Methods This study was structured according to the PRISMA-ScR (Preferred Reporting Items for Systematic Reviews and Meta-Analyses extension for Scoping Reviews) and Population, Intervention, Comparator, Outcome, and Study frameworks. Five databases (PubMed, the Cochrane Central Register of Controlled Trials, Web of Science, Embase, and PsycINFO) were systematically searched for studies published in English from 2014 onward. Two reviewers independently screened the references and selected studies for inclusion based on the eligibility criteria. Data were systematically extracted per research question, which were synthesized in a descriptive analysis. Results A wide variety of study characteristics, including the number and age of participants, study duration, and type of digital intervention, were identified. There was mixed evidence for the effectiveness of the interventions. Of the 10 studies that evaluated treatment adherence, 7 (70%) found improvements, but the evidence was inconsistent for asthma control (6/9, 67% of studies reported improvement or maintenance, but only 1 was significantly different between groups) and health outcome variables (5/9, 56% of studies found no evidence of effectiveness). The 6 studies that examined patient perceptions and assessments of acceptability and usability generally had positive findings. Conclusions A wide range of digital interventions are being developed and evaluated to support the monitoring and treatment adherence of children and adolescents with asthma. Meta-analyses are inhibited by the use of samples with a variety of overlapping age ranges; a theoretical framework for evaluating specific age groups would aid comparison between studies. Most studies found significant evidence for improved adherence to treatment or medications, but there was mixed evidence of the impact of the digital interventions on asthma control and other health outcomes. There are gaps in the literature relating to cost-effectiveness and integration with existing clinical care pathways. This study will be necessary to determine which digital interventions for children and young people with asthma are worth supporting and adopting in the clinical care pathways.

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eHealth Technologies for Monitoring Pediatric Asthma at Home: Scoping Review

Kamp¹,

Hengeveld²,

Brusse-Keizer³

et al. 2023

J Med Internet Res

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Background eHealth monitoring technologies offer opportunities to more objectively assess symptoms when they appear in daily life. Asthma is the most common chronic disease in childhood with an episodic course, requiring close follow-up of pediatric asthma control to identify disease deterioration, prevent exacerbations, and enhance quality of life. eHealth technologies in pediatric asthma care show promising results regarding feasibility, acceptability, and asthma-related health outcomes. However, broad systematic evaluations of eHealth technologies in pediatric asthma are lacking. Objective The objective of this scoping review was to identify the types and applications of eHealth technologies for monitoring and treatment in pediatric asthma and explore which monitoring domains show the most relevance or potential for future research. Methods A scoping review was conducted using the PRISMA-ScR (Preferred Reporting Items for Systematic Reviews and Meta-Analyses extension for Scoping Reviews) guidelines. A systematic and comprehensive search was performed on English papers that investigated the development, validation, or application of eHealth technologies for home monitoring or treatment of pediatric asthma in the following databases: PubMed, Cochrane Library, IEEE, Scopus, CINAHL, PsycINFO, and ACM Digital Library. Two authors independently assessed eligibility and extracted data. Data were presented by a descriptive analysis of characteristics and a narrative report for each eHealth domain. Results The review included 370 manuscripts. The following 10 monitoring domains were identified: air quality, airway inflammation markers, lung function, physical activity, sleep, audiovisual, other physiological measurements, questionnaires, medication monitoring, and digital environment (ie, digital platforms, applications, websites, and software tools to monitor or support monitoring). Rising numbers of studies were seen, and the numbers accelerated in the last few years throughout most domains, especially medication monitoring and digital environment. Limited studies (35/370, 9.5%) of multiparameter monitoring strategies, using three or more domains, were found. The number of monitoring validation studies remained stable, while development and intervention studies increased. Intervention outcomes seemed to indicate the noninferiority and potential superiority of eHealth monitoring in pediatric asthma. Conclusions This systematic scoping review provides a unique overview of eHealth pediatric asthma monitoring studies, and it revealed that eHealth research takes place throughout different monitoring domains using different approaches. The outcomes of the review showed the potency for efficacy of most monitoring domains (especially the domains of medication monitoring, lung function, and digital environment). Future studies could focus on modifying potentially relevant hospital-based diagnostics for the home setting to investigate potential beneficial effects and focus on combining home-monitoring domains to facilitate multiparameter decision-making and personalized clinical decision support.

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A Prospective, Randomized, Controlled Study of Inhaler Electronic Monitoring Devices to Improve Adherence in Children with Asthma

Cited by 4 publications

References 0 publications

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

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

Digital Technologies for Monitoring and Improving Treatment Adherence in Children and Adolescents With Asthma: Scoping Review of Randomized Controlled Trials

eHealth Technologies for Monitoring Pediatric Asthma at Home: Scoping Review

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