Search citation statements
Paper Sections
Citation Types
Year Published
Publication Types
Relationship
Authors
Journals
BACKGROUND Electronic monitoring devices (EMDs) are increasingly considered the gold standard for quantifying inhaled corticosteroid (ICS) adherence in asthma. They are likely to play an important role in the future digitisation of self-management. However, there is a risk that early adoption without clarity of purpose could limit their utility. OBJECTIVE This review sought to ascertain an estimate of EMD-measured ICS adherence among people with asthma and understand the factors involved in their use. METHODS Searches were conducted in 2017 with updates in 2021 and 2023 across databases including Cochrane CENTRAL, MEDLINE, EMBASE, Web of Science, PsychINFO and IEEE Xplore. Studies were included if they used EMDs in adults with asthma and were randomised controlled trials (RCTs) or cohort studies. Summary data were extracted to inform narrative review and meta-analysis. The primary outcome was to derive a population estimate of ICS adherence. The study protocol is registered on the Prospero database (CRD42017057708). RESULTS Seventy-two RCTs and cohort studies were identified. RCT control groups were pooled with cohort studies for meta-analysis of the primary endpoint. Mean daily ICS adherence was 63.7% (95% Confidence Interval 59.2–68.2%, I2=98.9%). There was significant heterogeneity in device characteristics, study design, sample populations, definitions of adherence and use/choice of clinical outcome measures. CONCLUSIONS The findings suggest studies likely overestimate adherence compared to the general asthma population, even when objectively monitored. Minimum agreed standards for EMD outputs, accuracy, and agreed clinical outcome measures which are sensitive to digital interventions may be required for future research and clinical practice. CLINICALTRIAL N/A
BACKGROUND Electronic monitoring devices (EMDs) are increasingly considered the gold standard for quantifying inhaled corticosteroid (ICS) adherence in asthma. They are likely to play an important role in the future digitisation of self-management. However, there is a risk that early adoption without clarity of purpose could limit their utility. OBJECTIVE This review sought to ascertain an estimate of EMD-measured ICS adherence among people with asthma and understand the factors involved in their use. METHODS Searches were conducted in 2017 with updates in 2021 and 2023 across databases including Cochrane CENTRAL, MEDLINE, EMBASE, Web of Science, PsychINFO and IEEE Xplore. Studies were included if they used EMDs in adults with asthma and were randomised controlled trials (RCTs) or cohort studies. Summary data were extracted to inform narrative review and meta-analysis. The primary outcome was to derive a population estimate of ICS adherence. The study protocol is registered on the Prospero database (CRD42017057708). RESULTS Seventy-two RCTs and cohort studies were identified. RCT control groups were pooled with cohort studies for meta-analysis of the primary endpoint. Mean daily ICS adherence was 63.7% (95% Confidence Interval 59.2–68.2%, I2=98.9%). There was significant heterogeneity in device characteristics, study design, sample populations, definitions of adherence and use/choice of clinical outcome measures. CONCLUSIONS The findings suggest studies likely overestimate adherence compared to the general asthma population, even when objectively monitored. Minimum agreed standards for EMD outputs, accuracy, and agreed clinical outcome measures which are sensitive to digital interventions may be required for future research and clinical practice. CLINICALTRIAL N/A
scite is a Brooklyn-based organization that helps researchers better discover and understand research articles through Smart Citations–citations that display the context of the citation and describe whether the article provides supporting or contrasting evidence. scite is used by students and researchers from around the world and is funded in part by the National Science Foundation and the National Institute on Drug Abuse of the National Institutes of Health.
customersupport@researchsolutions.com
10624 S. Eastern Ave., Ste. A-614
Henderson, NV 89052, USA
This site is protected by reCAPTCHA and the Google Privacy Policy and Terms of Service apply.
Copyright © 2024 scite LLC. All rights reserved.
Made with 💙 for researchers
Part of the Research Solutions Family.