Tailored Adherence Incentives for Childhood Asthma Medications: A Randomized Clinical Trial

Area of Science:

• Pediatric Health
• Clinical Trials
• Health Disparities

Background:

• Differential adherence to preventive medications contributes to racial disparities in childhood asthma.
• Targeting adherence is crucial for improving asthma outcomes in minority children.

Purpose of the Study:

• To assess the impact of a financial incentive-enhanced intervention on adherence to inhaled asthma preventive medication.
• To evaluate this intervention in a high-risk, predominantly racially minoritized pediatric cohort.

Main Methods:

• A randomized clinical trial involving children aged 5-12 with persistent asthma.
• Intervention included daily text reminders, weekly feedback, and financial incentives for medication adherence.
• Adherence was monitored using electronic inhaler sensors over a 7-month period (3-month intervention, 3-month observation).

Main Results:

• The full intervention group showed a 15-percentage point higher adherence compared to the active control group during the intervention period.
• No significant differences in adherence were observed between groups during the 3-month observation phase after the intervention ceased.
• The study included 106 children, with 82% identifying as non-Hispanic Black.

Conclusions:

• Financial incentive-enhanced mobile health interventions can temporarily improve inhaled preventive medication adherence in children.
• The positive effects on adherence did not persist after the intervention components were removed.
• Findings suggest that while incentives can boost adherence, their long-term impact requires further investigation.