Assessing adolescent asthma symptoms and adherence using mobile phones

Area of Science:

• Digital Health
• Adolescent Medicine
• Asthma Management

Background:

• Traditional self-report for medication adherence is limited by recall bias and lacks insight into adherence barriers.
• Ecological Momentary Assessment (EMA) via mobile phones presents a viable alternative for real-time adherence monitoring and data collection.

Purpose of the Study:

• To evaluate the feasibility of using mobile phone-based EMA for assessing adolescent asthma medication adherence.
• To identify contextual factors influencing adolescent adherence decision-making in asthma management.

Main Methods:

• A descriptive and correlational study employed an interactive voice response system for daily symptom and adherence assessments over one month.
• Adolescents (12-18 years) with asthma received daily calls, supplemented by baseline and follow-up surveys including the Asthma Control Test (ACT).
• Data collected included asthma symptoms, rescue inhaler adherence, barriers to mobile phone use, and quality of life.

Main Results:

• Adolescents responded to an average of 67% of daily calls, with adherence declining towards the end of the study month.
• EMA revealed that 53% of nonadherence instances occurred in social settings with friends, highlighting social context.
• EMA-adherence correlated significantly with asthma control as measured by the ACT, validating the EMA approach.

Conclusions:

• Mobile phone-based EMA is a feasible method for assessing asthma symptoms and medication adherence in adolescents.
• EMA provides valuable contextual data on adherence decision-making, useful for clinical interventions and patient feedback systems.
• This approach supports personalized asthma management strategies by uncovering real-world adherence challenges.