A tailored mobile health intervention to improve adherence and asthma control in minority adolescents

Mosnaim, Giselle; Li, Hong; Martin, Molly A.; Richardson, DeJuran; Belice, Paula Jo; Avery, Elizabeth; Silberstein, Agustina; Leigh, Jason; Kenyon, Robert V.; Jones, Steven G.; Bender, Bruce G.; Powell, Lynda H.

doi:10.1016/j.jaip.2014.10.011

Cited by 65 publications

(88 citation statements)

References 7 publications

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“…Results again showed improved medication adherence as well as an increase in ACT scores. 15 Certainly, this is a meaningful result and demonstrates proof-of-principle in a challenging patient population.…”

Section: Discussionmentioning

confidence: 62%

“…In comparison, Burbank et al 21 observed an increase of 2 points (from 16 to 18) in the median ACT score with their mobile asthma action plan targeted at adolescents. 21 Mosnaim et al 15 observed an increase of 3 points in the ACT score in 58% of their inner-city adolescent patients. It is certainly worth noting that demographic characteristics of patients in our study differed substantially in terms of socioeconomic status, age, and asthma phenotypes.…”

Section: Discussionmentioning

confidence: 97%

“…13 Although smartphone apps may address all these areas, there is an overemphasis on the use of medication reminders to improve adherence. 14,15 A comprehensive approach targeting all 3 objectives is more likely to yield robust, long-lasting improvements in adherence and asthma outcomes. In this study, we describe a smartphone app emphasizing patient education and self-care with proactive, individualized “coaching” based on National Asthma Education and Prevention Program treatment guidelines.…”

mentioning

confidence: 99%

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Improvement in Asthma Control Using a Minimally Burdensome and Proactive Smartphone Application

Cook

Modena

Simon

2016

The Journal of Allergy and Clinical Immunology: In Practice

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BACKGROUND Integrated chronic disease treatment models that enable patient self-care and shared treatment decision making have recently been shown to improve medication adherence and outcomes. Smartphone applications (apps) are a readily available means to enable this model, although sustained user engagement remains a challenge. OBJECTIVE To assess the efficacy of improving asthma control using a proactive smartphone app without required regular inputs. METHODS We designed a minimally intrusive smartphone app to provide individualized and timely support to patients with asthma based on the National Asthma Education and Prevention Program guidelines and Scripps management pathways. In this proof-of-concept study, we enrolled 60 adults with poorly controlled asthma to test the usability and effectiveness of this app over a 4-month period. The Asthma Control Test survey was used to assess control before, during, and after app use. As a corollary, a retrospective chart review was also used to assess changes in lung function and prescribed courses of systemic corticosteroids. RESULTS Our patients, with a mean age of 50 years, reported an improvement in Asthma Control Test scores from 16.6 (inadequate to poor) to 20.5 (controlled) over the study period. Concurrently, there was a 7.9% absolute increase in FEV1, while courses of systemic corticosteroids decreased from 0.5 to 0.3 courses per 6-month period. Fifty-eight of 60 patients completed the final survey, with high satisfaction reported. CONCLUSIONS This app improved asthma control in a cohort of patients with uncontrolled asthma (age range, 17–82 years), while minimizing burdensome inputs and proactively providing individualized teaching and treatment support. The app and treatment model are scalable to cost-effectively manage chronic disease.

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Section: Discussionmentioning

confidence: 62%

Section: Discussionmentioning

confidence: 97%

mentioning

confidence: 99%

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Improvement in Asthma Control Using a Minimally Burdensome and Proactive Smartphone Application

Cook

Modena

Simon

2016

The Journal of Allergy and Clinical Immunology: In Practice

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“…Mobile phone applications may be more appropriate to educate children and adolescents: a survey among children and adolescents in Europe and Japan aged 9-16 years found that, on average, 69% used a mobile phone, which was a smartphone in two-thirds of the cases (57). The easy accessibility of serious games integrated in mobile applications on smartphones may enhance their effectiveness as educational tools, but to our knowledge, the three educational games developed on mobile applications for children with asthma were not evaluated (58). This approach is nevertheless supported by the demonstration that an app which associated reminders and positive reinforcement, although not being a SG, was effective in improving adherence and asthma control among underserved minority adolescents (59).…”

Section: Discussionmentioning

confidence: 95%

A systematic review of serious games in asthma education

Drummond

Monnier

Tesnière

et al. 2017

Pediatric Allergy Immunology

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“…Healthcare providers may therefore serve as a means of information about acceptable applications that may serve to improve adherence outcomes through validated means in technologically savvy patients. Novel strategies utilizing gamification and incentive strategies have additionally been introduced to this population, 84 though long‐term outcomes of these types of strategies remain unclear. In addition, novel behavior change strategies continue to be developed including the new and exciting area termed “nudging,” defined as “Interventions that involve altering the properties or placement of objects or stimuli within micro‐environments with the intention of changing health‐related behavior.…”

Section: Patient and Family Level Factorsmentioning

confidence: 99%

They just don't take their medicines: Reframing medication adherence in asthma from frustration to opportunity

Keyser

Ramsey

Federico

2020

Pediatric Pulmonology

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Assessing and addressing suboptimal adherence to asthma medications is a key component in the treatment of all children with asthma, particularly those with difficult‐to‐treat asthma. However, parents often overreport adherence to asthma medications. Increased medication adherence could lead to improved outcomes in the form of better asthma control and decreased asthma exacerbations, as well as decreased healthcare utilization costs. Yet there are many complex factors that affect medication adherence, and barriers are often different in each family. Social determinants of health, complex healthcare relationships, and patient‐related factors may all affect medication adherence. Multicomponent patient‐centered strategies, as well as strategies that utilize technology and habit formation strategies may be helpful in improving medication adherence. Further study is needed to reliably and sustainably improve medication adherence in children with asthma across the broader population; in some populations, alternate diagnoses, adjusting therapy, and other intervention may be required to improve asthma control and health.

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A tailored mobile health intervention to improve adherence and asthma control in minority adolescents

Cited by 65 publications

References 7 publications

Improvement in Asthma Control Using a Minimally Burdensome and Proactive Smartphone Application

Improvement in Asthma Control Using a Minimally Burdensome and Proactive Smartphone Application

A systematic review of serious games in asthma education

They just don't take their medicines: Reframing medication adherence in asthma from frustration to opportunity

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