Digital interventions to improve adherence to maintenance medication in asthma

Area of Science:

• Digital health interventions
• Respiratory medicine
• Clinical trial methodology

Background:

• Asthma affects 334 million globally, with suboptimal adherence to inhaled corticosteroids (ICS) leading to severe outcomes.
• Poor adherence to ICS increases asthma symptoms, exacerbations, hospitalizations, and mortality.
• The effectiveness of digital interventions on asthma medication adherence remains largely unknown.

Purpose of the Study:

• To evaluate the efficacy of digital interventions in improving adherence to maintenance treatments for asthma.
• To assess the impact of digital tools on asthma control, exacerbations, healthcare utilization, lung function, and quality of life.

Main Methods:

• Systematic review and meta-analysis of 40 randomized controlled trials (RCTs) involving 15,207 adult and pediatric asthma patients.
• Inclusion criteria: RCTs comparing digital adherence interventions with non-digital interventions or usual care.
• Outcomes assessed: medication adherence, asthma control, exacerbations, healthcare utilization, lung function (FEV1), and quality of life.

Main Results:

• Digital interventions showed a potential increase in adherence by 14.66 percentage points (low-certainty evidence).
• Electronic monitoring devices (EMDs) and short message services (SMS) significantly improved adherence.
• Moderate-certainty evidence indicates improvements in asthma control and quality of life, with potential reductions in asthma exacerbations.

Conclusions:

• Digital interventions offer a promising strategy to enhance medication adherence and improve asthma control and quality of life.
• EMDs and SMS interventions are effective, with potential added benefits from in-person components and adherence feedback.
• Further research should standardize adherence measurement and utilize validated outcome assessment tools.