A Pilot Study of the Effect of an Educational Web Application on Asthma Control and Medication Adherence

Publication date: Available online 12 January 2019

Source: The Journal of Allergy and Clinical Immunology: In Practice

Author(s): Andrew G. Weinstein, Anil Singh, Jean-Philippe Laurenceau, David P. Skoner, Jennifer Maiolo, Rihab Sharara, Kiet Ma, Tariq Cheema, Erica Butler, Allison Kong, Payal Thakkar, Deborah A. Gentile

Abstract

Background

An Asthma Adherence Pathway^™ (AAP) application, which is an internet application that combines patient and clinician education strategies to promote adherence to asthma therapy, has been developed.

Objective

The primary objective of this pilot study was to evaluate the effectiveness of the AAP application with electronic adherence monitors on asthma control. Secondary objectives evaluated the effect of AAP and monitors on medication adherence, asthma symptoms, QOL, psychosocial factors, and barriers to treatment.

Methods

Adult asthma patients were randomly assigned either to intervention (n=19) or control (n=20) groups in this 3-month prospective study and completed the Asthma Control Questionnaire (ACQ). Intervention patients completed the AAP software and were given barrier-specific motivational interviewing adherence strategies (MIAS) and a SmartTrack device to monitor mometasone furoate/formoterol (MF/F) use. Clinicians in the interventional group received adherence management training. Interventional patients were given feedback regarding adherence findings at each visit. Treatment adherence was determined by the mean of 4 measures of doses taken over 3 months. Control patients were not monitored for MF/F adherence.

Results

Mean MF/F adherence in the intervention group was 81%. The intervention and control groups did not differ on mean baseline ACQ. Thirteen intervention patients achieved minimal important difference (defined as an improvement ≥0.5 units on ACQ) compared to 6 control patients (p=0.016). The intervention group showed greater improvement in ACQ (0.75) than the control group (0.19) representing a moderate-to-large effect size of d=0.638.

Conclusions

The AAP was effective in promoting adherence and helped to improve asthma control. These findings provide preliminary validation of the AAP model.

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