Systematic Review of Digital Interventions for Pediatric Asthma Management

Rachelle R Ramsey; Jill M Plevinsky; Sophie R Kollin; Robert C Gibler; Theresa W Guilbert; Kevin A Hommel

doi:10.1016/j.jaip.2019.12.013

Systematic Review of Digital Interventions for Pediatric Asthma Management

J Allergy Clin Immunol Pract. 2020 Apr;8(4):1284-1293. doi: 10.1016/j.jaip.2019.12.013. Epub 2019 Dec 21.

Authors

Rachelle R Ramsey¹, Jill M Plevinsky², Sophie R Kollin², Robert C Gibler³, Theresa W Guilbert⁴, Kevin A Hommel⁵

Affiliations

¹ Division of Behavioral Medicine and Clinical Psychology, Cincinnati Children's Hospital Medical Center, Cincinnati, Ohio; Department of Pediatrics, University of Cincinnati College of Medicine, Cincinnati, Ohio. Electronic address: rachelle.ramsey@cchmc.org.
² Division of Behavioral Medicine and Clinical Psychology, Cincinnati Children's Hospital Medical Center, Cincinnati, Ohio.
³ Department of Psychology, University of Cincinnati, Cincinnati, Ohio.
⁴ Department of Pediatrics, University of Cincinnati College of Medicine, Cincinnati, Ohio; Division of Pulmonary Medicine, Cincinnati Children's Hospital Medical Center, Cincinnati, Ohio.
⁵ Division of Behavioral Medicine and Clinical Psychology, Cincinnati Children's Hospital Medical Center, Cincinnati, Ohio; Department of Pediatrics, University of Cincinnati College of Medicine, Cincinnati, Ohio.

Abstract

Background: Pediatric patients with asthma take only approximately half of their prescribed medication. Digital interventions to improve adherence for youth with asthma exist and have the potential to improve accessibility, cost-effectiveness, and customizability.

Objective: To systematically review published research examining digital interventions to promote adherence to the treatment of pediatric asthma.

Methods: A systematic search of the PubMed, Scopus, CINAHL, PsycINFO, and reference review databases was conducted. Articles were included if adherence was an outcome in a randomized controlled trial of a digital intervention for children with asthma. We compared samples, intervention characteristics, adherence measurement and outcomes, as well as additional health outcomes across studies.

Results: Of the 264 articles reviewed, 15 studies met inclusion criteria and were included in the review. Overall, 87% of the digital interventions demonstrated improved adherence and 53% demonstrated improved health outcomes. All the promising interventions included a behavioral component and most were 3 to 6 months in length, delivered through a digital stand-alone medium (eg, automated personalized texts, mobile health apps, and website), and assessed adherence to controller medication.

Conclusions: Overall, digital interventions aimed at improving adherence are promising and also improve health outcomes in addition to medication adherence. Although future studies using evidence-based adherence assessment and multifactorial design should be conducted, the current literature suggests that both digital stand-alone interventions and interventions combining digital technology with support from a health care team member result in improved adherence and asthma outcomes. Recommendations for digital interventions for pediatric patients with asthma with adherence concerns are provided.

Keywords: Adherence; Asthma; Digital intervention; Internet; Mobile health; Self-management.

Publication types

Research Support, N.I.H., Extramural
Systematic Review

MeSH terms

Adolescent
Asthma* / drug therapy
Child
Humans
Medication Adherence
Mobile Applications*

Abstract

Publication types

MeSH terms

Grants and funding