Related Experiment Video
Updated: Dec 20, 2025
Setup of Consumer Wearable Devices for Exposure and Health Monitoring in Population Studies
Published on: February 3, 2023
Tailored Medication Adherence Incentives Using mHealth for Children With High-Risk Asthma (TAICAM): Protocol for a
Brittney R Henderson1, Carina M Flaherty1, G Chandler Floyd1
1Roberts Center for Pediatric Research, Children's Hospital of Philadelphia, Philadelphia, PA, United States.
Insights
Financial incentives may improve adherence to inhaled corticosteroids in high-risk pediatric asthma patients. This study investigates sustained adherence and healthcare impacts of such interventions.
Area of Science:
- Pediatric pulmonology
- Health services research
- Digital health interventions
Background:
- Poor adherence to inhaled corticosteroids (ICS) is prevalent in high-risk pediatric asthma, disproportionately affecting minority urban populations.
- Financial incentives show promise for engaging this population, but their long-term effectiveness in maintaining adherence is unknown.
Purpose of the Study:
- To determine the marginal effects of a financial incentive-based intervention on ICS adherence.
- To evaluate the intervention's impact on healthcare system utilization and associated costs.
Main Methods:
- Children aged 5-12 with high-risk asthma were enrolled, using electronic inhaler sensors to track ICS use over 7 months.
- After a 1-month observation, participants were randomized into three groups: financial incentives with reminders/feedback, reminders/feedback only, or no intervention.
- A subsequent 3-month follow-up assessed sustained adherence without intervention.
Main Results:
- Enrollment began September 2019; 61 of 125 target children were enrolled by June 2020.
- Data collection is projected to conclude by June 2022, with analysis completed by June 2023.
Conclusions:
- This study will provide crucial data on the long-term efficacy of financial incentive-based mobile health interventions for ICS adherence in high-risk pediatric asthma.
- Findings will inform strategies for sustained adherence and potentially reduce healthcare utilization in this vulnerable population.
Background:
Poor adherence to inhaled corticosteroid medications for children with high-risk asthma is both well documented and poorly understood. It has a disproportionate prevalence and impact on children of minority demographics in urban settings. Financial incentives have been shown to be a compelling method to engage those in a high-risk asthma population, but whether adherence can be maintained by offering financial incentives and how these incentives can be used to sustain high adherence are unknown.
Objective:
The aim of this study is to determine the marginal effects of a financial incentive-based intervention on inhaled corticosteroid adherence, health care system use, and costs.
Methods:
Participants include children aged 5 to 12 years who have had either at least two hospitalizations or one hospitalization and one emergency department visit for asthma in the year prior to their enrollment (and their caregivers). Participants are given an electronic inhaler sensor in order to track their medication use over a period of 7 months. After a 1-month period of observation, participants are randomized to 1 of 3 arms for a 3-month period. Participants in arm 1 receive daily text message reminders, feedback, and gain-framed, nominal financial incentives; participants in arm 2 receive daily text message reminders and feedback only, and participants in arm 3 receive no reminders, feedback, or incentives. All participants are subsequently observed for an additional 3-month period with no reminders, feedback, or incentives to assess whether any sustained effects are apparent.
Results:
Study enrollment began in September 2019 with a target sample size of N=125 children. As of June 2020, 61 children have been enrolled. Data collection is estimated to be completed in June 2022, and analyses will be completed by June 2023.
Conclusions:
This study will provide data that will help to determine whether a financial incentive-based mobile health intervention for promoting inhaled corticosteroid use can be effective in patients with high-risk asthma over longer periods.
Trial Registration:
Clinicaltrial.gov NCT03907410; https://clinicaltrials.gov/ct2/show/NCT03907410.
International Registered Report Identifier (Irrid):
DERR1-10.2196/16711.
Related Concept Videos
01:30Asthma-IV: Nursing Management
First, in...
01:30Asthma-IV: Diagnostic and Management
Clinical Assessment for Asthma:
This is the first step in diagnosing and managing asthma. It includes:
01:29Asthma-I: Introduction
01:13Randomized Experiments
Simple randomization
Simple...
01:11Blinding
01:20Asthma: Pathogenesis and Management
Asthma is classified as allergic and non-allergic. Allergens such as dust mites, pollen, and pet dander trigger allergic asthma, while factors like cold air, intense emotions, or exercise can induce non-allergic asthma.