Smartphones for Real-time Assessment of Adherence Behavior and Symptom Exacerbation for High-Risk Youth with Asthma: Pilot Study
| Autor: | Frank A. Treiber, Anita B Shuler, Kenneth J. Ruggiero, Erin Dawley, Ronald J. Teufel, Sachin Patel, Martina Mueller, Myla Ebeling, Michelle Nichols, Anne L. Andrews |
|---|---|
| Rok vydání: | 2018 |
| Předmět: |
medicine.medical_specialty
Short Message Service 020205 medical informatics Biomedical Engineering Medication adherence Health Informatics 02 engineering and technology 03 medical and health sciences 0302 clinical medicine children Acute care 0202 electrical engineering electronic engineering information engineering Medicine mHealth Asthma Original Paper mobile phone youth business.industry Inhaler ecological momentary assessment Boredom medicine.disease 3. Good health Computer Science Applications Test (assessment) 030228 respiratory system Family medicine medication adherence Pediatrics Perinatology and Child Health symptoms medicine.symptom business medication monitoring device |
| Zdroj: | JMIR Pediatrics and Parenting |
| ISSN: | 2561-6722 |
| DOI: | 10.2196/pediatrics.9796 |
| Popis: | Background Youth with asthma who have poor medication adherence, have limited access to care, and are frequently seen in the acute care setting are often termed "high risk." Objective This study aimed to design and test the feasibility of using smartphone technology to assess contextual factors that may impact changes in daily medication adherence and to identify new symptom episodes among high-risk youth with asthma in their home environment. Methods Youth aged 8-17 years with high-risk asthma from 2 children's hospitals were eligible for the 2-month study. An app was downloaded on participants' phones at enrollment. Daily text message (short message service) 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. The acceptability was assessed with surveys, key informant interviews (KII), and frequency of days with asthma data. KII data were used in an iterative design approach to identify challenges, strengths, and suggestions for maximizing use. Generalized linear mixed modeling was used to preliminarily explore contextual factors associated with changes in daily adherence. Results We enrolled 14 children aged 8-16 years (13/14, 93% were African Americans). Over the 2-month study period, participants reported coughing (42/110, 38%), wheezing (8/111, 7%), chest tightness (9/109, 8%), boredom (57/109, 52%), and 10 new asthma symptom episodes. The controller medication adherence was 30%, which increased significantly on days with asthma symptoms or boredom. Data were received on 89% (606/681) of study days. Surveys and KIIs suggest acceptability among youth and their caregivers. Challenges reported during the study included lost or damaged phones and available memory. Conclusions Youth and their caregivers reported the acceptability of using smartphones for real-time asthma monitoring. Overall, the controller medication adherence was low but increased significantly on days with reported asthma symptoms or boredom, suggesting that daily contextual factors may be associated with a change in the adherence behavior. |
| Databáze: | OpenAIRE |
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