Patient acceptability and reliability of an electronic adherence intervention in asthma

Abstract

Background: Electronic adherence monitoring devices are increasingly being used in interventions to improve patient health behaviours, in particular medication adherence. Little is known about the patient-acceptability of these devices or how reliably the devices perform in children. This study aimed to investigate the acceptability and reliability of an electronic adherence monitoring device in a childhood asthma population. Methods: A total of 220 children, aged 6 to 15 years, presenting with asthma to the emergency department and prescribed inhaled corticosteroids for control of asthma, were included. Participants were randomized to receive an adherence monitoring device with twice-daily reminders for missed doses enabled (active group) or disabled (control group) as an adherence intervention. Quantitative and qualitative measures of device acceptability, utility and ergonomics were completed after six months. Device reliability tests were conducted before device issue and after device return. Findings: Most (>90%) rated the device easy to use. Qualitative reports were high for device acceptability and across five other themes, including effect on medication use and on asthma control. The majority of devices passed pre-issue (84%) and return (87%) reliability testing. The most common error was failure to record one or more inhaler doses taken. Discussion: This is the first study to investigate the acceptability and reliability of an electronic adherence monitoring device in children. Results indicate favourable acceptability that supports the potential use of these devices as adherence interventions. Device reliability was satisfactory, though failure rates of 13-16% highlight the importance of reliability testing before and after device use.