Automated Adherence Reminders for High Risk Children With Asthma: A Research Protocol

Area of Science:

• Pediatric Asthma Management
• Mobile Health Interventions
• Health Disparities

Background:

• Inhaled corticosteroid (ICS) use improves asthma control, reducing morbidity and mortality.
• Electronic monitoring and reminders significantly boost ICS adherence in prior trials.
• Urban minority populations face challenges with ICS adherence, leading to worse asthma outcomes.

Purpose of the Study:

• Evaluate the feasibility and acceptability of SMS reminders for ICS adherence in urban minority children with asthma.
• Assess the limited efficacy of SMS reminders on ICS adherence and asthma control.
• Examine ICS adherence trajectories post-hospitalization.

Main Methods:

• 40 children (2-13 years) hospitalized for asthma at CHOP were randomized (1:1) to intervention or control.
• Intervention group received daily SMS reminders for 30 days post-hospitalization.
• Feasibility assessed by retention and participant feedback; efficacy by adherence (Propeller Health sensors) and parent-reported control.

Main Results:

• Enrollment began December 2015; intervention and follow-up phases are ongoing.
• Data analysis results are anticipated by December 2016.
• Exploratory analysis using group-based trajectory modeling (GBTM) will assess adherence patterns.

Conclusions:

• This study provides crucial feasibility data for mobile health interventions in high-risk urban minority populations.
• Findings will inform modifications to text message reminder systems for better patient engagement.
• The research addresses a critical need to improve asthma care in underserved communities.