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Systematic Review of Digital Interventions for Pediatric Asthma Management
Rachelle R Ramsey1, Jill M Plevinsky2, Sophie R Kollin2
1Division of Behavioral Medicine and Clinical Psychology, Cincinnati Children's Hospital Medical Center, Cincinnati, Ohio; Department of Pediatrics, University of Cincinnati College of Medicine, Cincinnati, Ohio.
Insights
Digital interventions significantly improve medication adherence and health outcomes for pediatric asthma patients. These tools offer accessible, customizable, and cost-effective solutions for improving treatment compliance in youth.
Area of Science:
- Digital health
- Pediatric pulmonology
- Behavioral science
Background:
- Pediatric asthma patients adhere to only half of prescribed medications.
- Digital interventions offer accessible, cost-effective, and customizable adherence solutions for youth.
Purpose of the Study:
- To systematically review research on digital interventions for pediatric asthma treatment adherence.
Main Methods:
- Systematic search of multiple databases (PubMed, Scopus, CINAHL, PsycINFO).
- Included randomized controlled trials of digital interventions for children with asthma where adherence was an outcome.
- Compared intervention characteristics, adherence, and health outcomes.
Main Results:
- 15 studies met inclusion criteria.
- 87% of digital interventions improved adherence; 53% improved health outcomes.
- Effective interventions included behavioral components, lasted 3-6 months, and used digital platforms (apps, texts, websites).
Conclusions:
- Digital interventions are promising for improving pediatric asthma medication adherence and health outcomes.
- Both standalone digital tools and those combined with healthcare support show improved adherence.
- Future research should focus on evidence-based adherence assessment and multifactorial designs.
Background:
Pediatric patients with asthma take only approximately half of their prescribed medication. Digital interventions to improve adherence for youth with asthma exist and have the potential to improve accessibility, cost-effectiveness, and customizability.
Objective:
To systematically review published research examining digital interventions to promote adherence to the treatment of pediatric asthma.
Methods:
A systematic search of the PubMed, Scopus, CINAHL, PsycINFO, and reference review databases was conducted. Articles were included if adherence was an outcome in a randomized controlled trial of a digital intervention for children with asthma. We compared samples, intervention characteristics, adherence measurement and outcomes, as well as additional health outcomes across studies.
Results:
Of the 264 articles reviewed, 15 studies met inclusion criteria and were included in the review. Overall, 87% of the digital interventions demonstrated improved adherence and 53% demonstrated improved health outcomes. All the promising interventions included a behavioral component and most were 3 to 6 months in length, delivered through a digital stand-alone medium (eg, automated personalized texts, mobile health apps, and website), and assessed adherence to controller medication.
Conclusions:
Overall, digital interventions aimed at improving adherence are promising and also improve health outcomes in addition to medication adherence. Although future studies using evidence-based adherence assessment and multifactorial design should be conducted, the current literature suggests that both digital stand-alone interventions and interventions combining digital technology with support from a health care team member result in improved adherence and asthma outcomes. Recommendations for digital interventions for pediatric patients with asthma with adherence concerns are provided.
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