PMID- 33154086
OWN - NLM
STAT- MEDLINE
DCOM- 20211124
LR  - 20220829
IS  - 2052-4439 (Electronic)
IS  - 2052-4439 (Linking)
VI  - 7
IP  - 1
DP  - 2020 Nov
TI  - Novel electronic adherence monitoring devices in children with asthma: a 
      mixed-methods study.
LID - 10.1136/bmjresp-2020-000589 [doi]
LID - e000589
AB  - INTRODUCTION: Adherence monitoring to inhaled corticosteroids is an essential 
      component of asthma management. Electronic monitoring devices (EMD) provide 
      objective data on date, time and number of actuations. However, most give no 
      information on inhalation. Novel EMD (NEMD) platforms have the potential to 
      monitor both activation and inhalation. AIM: To assess the feasibility of NEMDs, 
      in terms of usability, acceptability to patients and healthcare professionals and 
      accuracy. METHODS: This was an open-label, prospective, mixed-methods, pragmatic 
      randomised study. Children with asthma attending specialist tertiary care were 
      randomised to one of four NEMD: Remote Directly Observed Therapy (R-DOT), Hailie 
      Smartinhaler, INhaler Compliance Assessment device (INCA) and the Rafi-tone App. 
      Following monitoring, participants were invited to focus groups or one-to-one 
      interviews. Usability and acceptability were evaluated using themes identified 
      from the focus groups and interviews. Adherence accuracy was determined using 
      adherence data from each NEMD. RESULTS: Thirty-five children were recruited; 18 
      (51%), (11 males, median age 13.5 (7-16) years) completed monitoring, 14 (78%) 
      provided feedback. Participants identified various features such as ease of use 
      and minimal effort as desirable criteria for an NEMD. The Hailie and INCA 
      fulfilled these criteria and were able to record both actuation and inhalation. 
      Negative themes included a 'Big Brother' effect and costs. CONCLUSION: There was 
      no 'one size fits all', as participants identified advantages and disadvantages 
      for each NEMD. Devices that can easily calculate adherence to activation and 
      inhalation have the potential to have greatest utility in clinical practice. Each 
      NEMD has different functionality and therefore choice of platform should be 
      determined by the needs of the patient and healthcare professional.
CI  - (c) Author(s) (or their employer(s)) 2020. Re-use permitted under CC BY-NC. No 
      commercial re-use. See rights and permissions. Published by BMJ.
FAU - Makhecha, Sukeshi
AU  - Makhecha S
AUID- ORCID: 0000-0002-6816-7478
AD  - Paediatrics, Respiratory, Royal Brompton Hospital, London, London, UK.
FAU - Chan, Amy
AU  - Chan A
AD  - The University of Auckland School of Pharmacy, Auckland, Auckland, New Zealand.
AD  - Centre of Behavioural Medicine, School of Pharmacy, UCL, London, London, UK.
FAU - Pearce, Christina
AU  - Pearce C
AD  - Centre of Behavioural Medicine, School of Pharmacy, UCL, London, London, UK.
FAU - Jamalzadeh, Angela
AU  - Jamalzadeh A
AD  - Paediatrics, Respiratory, Royal Brompton Hospital, London, London, UK.
FAU - Fleming, Louise
AU  - Fleming L
AD  - Paediatrics, Respiratory, Royal Brompton Hospital, London, London, UK 
      l.fleming@rbht.nhs.uk.
AD  - Imperial College London, London, London, UK.
LA  - eng
PT  - Journal Article
PT  - Randomized Controlled Trial
PT  - Research Support, Non-U.S. Gov't
PL  - England
TA  - BMJ Open Respir Res
JT  - BMJ open respiratory research
JID - 101638061
SB  - IM
MH  - Administration, Inhalation
MH  - Adolescent
MH  - *Asthma/drug therapy
MH  - Child
MH  - Electronics
MH  - Female
MH  - Humans
MH  - Male
MH  - *Medication Adherence
MH  - Prospective Studies
PMC - PMC7646352
OTO - NOTNLM
OT  - asthma
OT  - inhaler devices
OT  - paediatric asthma
COIS- Competing interests: None declared.
EDAT- 2020/11/07 06:00
MHDA- 2021/11/25 06:00
PMCR- 2020/11/05
CRDT- 2020/11/06 05:51
PHST- 2020/04/02 00:00 [received]
PHST- 2020/09/27 00:00 [revised]
PHST- 2020/09/29 00:00 [accepted]
PHST- 2020/11/06 05:51 [entrez]
PHST- 2020/11/07 06:00 [pubmed]
PHST- 2021/11/25 06:00 [medline]
PHST- 2020/11/05 00:00 [pmc-release]
AID - 7/1/e000589 [pii]
AID - bmjresp-2020-000589 [pii]
AID - 10.1136/bmjresp-2020-000589 [doi]
PST - ppublish
SO  - BMJ Open Respir Res. 2020 Nov;7(1):e000589. doi: 10.1136/bmjresp-2020-000589.