mHealth intervention to support asthma self-management in adolescents: the ADAPT study

Purpose Poor medication adherence in adolescents with asthma results in poorly controlled disease and increased morbidity. The aim of the ADolescent Adherence Patient Tool (ADAPT) study is to develop an mHealth intervention to support self-management and to evaluate the effectiveness in improving medication adherence and asthma control. Intervention The ADAPT intervention consists of an interactive smartphone application (app) connected to a desktop application for health care providers, in this study, the community pharmacist. The app contains several functions to improve adherence as follows: 1) a questionnaire function to rate asthma symptoms and monitor these over time; 2) short movie clips with medication and disease information; 3) a medication reminder; 4) a chat function with peers; and 5) a chat function with the pharmacist. The pharmacist receives data from the patient’s app through the desktop application, which enables the pharmacist to send information and feedback to the patient. Study design The ADAPT intervention is tested in a community pharmacy-based cluster randomized controlled trial in the Netherlands, aiming to include 352 adolescents with asthma. The main outcome is adherence, measured by patient’s self-report and refill adherence calculated from pharmacy dispensing records. In addition, asthma control, illness perceptions, medication beliefs, and asthma-related quality of life are measured. Conclusion This study will provide in-depth knowledge on the effectiveness of an mHealth intervention to support asthma self-management in adolescents. These insights will also be useful for adolescents with other chronic diseases.

[1]  Elizabeth Broadbent,et al.  The brief illness perception questionnaire. , 2006, Journal of psychosomatic research.

[2]  R. Haynes,et al.  Interventions for enhancing medication adherence. , 2008, The Cochrane database of systematic reviews.

[3]  D. Taddeo,et al.  Adherence to treatment in adolescents. , 2008, Paediatrics & child health.

[4]  M. Bouvy,et al.  Attitudes towards medication use in a general population of adolescents , 2014, European Journal of Pediatrics.

[5]  M. Bouvy,et al.  “I just forget to take it”: asthma self-management needs and preferences in adolescents , 2015, The Journal of asthma : official journal of the Association for the Care of Asthma.

[6]  G. Giaroli,et al.  Drug Attitude in Adolescents: A Key Factor for a Comprehensive Assessment , 2014, Journal of clinical psychopharmacology.

[7]  C. Sherbourne,et al.  The RAND 36-Item Health Survey 1.0. , 1993, Health economics.

[8]  D. Price,et al.  Achieving asthma control in practice: understanding the reasons for poor control. , 2008, Respiratory medicine.

[9]  M. Bouvy,et al.  Medication adherence in adolescents in current practice: community pharmacy staff's opinions , 2015, The International journal of pharmacy practice.

[10]  James F. Allen,et al.  Mobile phone-based asthma self-management aid for adolescents (mASMAA): a feasibility study , 2014, Patient preference and adherence.

[11]  G. Fritz,et al.  Medication adherence in pediatric asthma: reasoning, responsibility, and behavior. , 2003, Journal of pediatric psychology.

[12]  H. Rhee,et al.  Adolescents' psychosocial experiences living with asthma: a focus group study. , 2007, Journal of pediatric health care : official publication of National Association of Pediatric Nurse Associates & Practitioners.

[13]  J. Jongste,et al.  Astma bij kinderen , 2009 .

[14]  J. Car,et al.  Smartphone and tablet self management apps for asthma. , 2013, The Cochrane database of systematic reviews.

[15]  G. Roberts,et al.  Barriers and facilitators to asthma self‐management in adolescents: A systematic review of qualitative and quantitative studies , 2017, Pediatric pulmonology.

[16]  C. Rand,et al.  Measuring adherence to asthma medication regimens. , 1994, American journal of respiratory and critical care medicine.

[17]  R. Bal,et al.  Self-management interventions for young people with chronic conditions: A systematic overview. , 2015, Patient education and counseling.

[18]  Cecily Morrison,et al.  Apps for asthma self-management: a systematic assessment of content and tools , 2012, BMC Medicine.

[19]  J. Oppenheimer,et al.  Medication Adherence in the Asthmatic Child and Adolescent , 2011, Current allergy and asthma reports.

[20]  C. Rand,et al.  Adolescents and asthma: why bother with our meds? , 2008, The Journal of allergy and clinical immunology.

[21]  K. Buston,et al.  Non-compliance amongst adolescents with asthma: listening to what they tell us about self-management. , 2000, Family practice.

[22]  R. Horne,et al.  Beliefs about medicines predict refill adherence to inhaled corticosteroids. , 2008, Journal of psychosomatic research.

[23]  F. Petermann,et al.  Health‐Related Quality of Life in Children and Adolescents with Asthma: Results from the ESTAR Study , 2004, The Journal of asthma : official journal of the Association for the Care of Asthma.

[24]  J. Weinman,et al.  The beliefs about medicines questionnaire: The development and evaluation of a new method for assessing the cognitive representation of medication , 1999 .

[25]  A. Dean,et al.  A systematic review of interventions to enhance medication adherence in children and adolescents with chronic illness , 2010, Archives of Disease in Childhood.

[26]  M. Bouvy,et al.  The Utrecht Pharmacy Practice network for Education and Research: a network of community and hospital pharmacies in the Netherlands , 2014, International Journal of Clinical Pharmacy.

[27]  John Weinman,et al.  Self-regulation and Self-management in Asthma: Exploring The Role of Illness Perceptions and Treatment Beliefs in Explaining Non-adherence to Preventer Medication , 2002 .

[28]  V. Backer,et al.  Adherence to inhaled therapies, health outcomes and costs in patients with asthma and COPD. , 2013, Respiratory medicine.

[29]  M. Bouvy,et al.  Adolescents’ inhaled corticosteroid adherence: the importance of treatment perceptions and medication knowledge , 2015, The Journal of asthma : official journal of the Association for the Care of Asthma.

[30]  M. Cabana,et al.  At What Age Do Children Start Taking Daily Asthma Medicines on Their Own? , 2008, Pediatrics.

[31]  Tiago Jacinto,et al.  Control of Allergic Rhinitis and Asthma Test (CARAT): dissemination and applications in primary care , 2013, Primary care respiratory journal : journal of the General Practice Airways Group.

[32]  Pablo A. Mora,et al.  Using the common sense model to design interventions for the prevention and management of chronic illness threats: from description to process. , 2008, British journal of health psychology.

[33]  E. Juniper,et al.  Responsiveness, longitudinal- and cross-sectional construct validity of the Pediatric Asthma Quality of Life Questionnaire (PAQLQ) in Dutch children with asthma , 2005, Quality of Life Research.

[34]  Christina J. Jones,et al.  A systematic review of the effectiveness of interventions using the Common Sense Self-Regulatory Model to improve adherence behaviours , 2016, Journal of health psychology.

[35]  D. Nerenz,et al.  Illness Representations and Coping With Health Threats , 2020, Handbook of Psychology and Health (Volume IV).

[36]  M. Yi,et al.  Pilot and Feasibility Test of Adolescent-Controlled Text Messaging Reminders , 2012, Clinical pediatrics.