Giselle Mosnaim1, Hong Li2, Molly Martin2, DeJuran Richardson3, Paula Jo Belice2, Elizabeth Avery2, Norman Ryan4, Bruce Bender5, Lynda Powell2. 1. Department of Preventive Medicine, Rush Medical College, Chicago, Ill. Electronic address: giselle_mosnaim@rush.edu. 2. Department of Preventive Medicine, Rush Medical College, Chicago, Ill. 3. Department of Preventive Medicine, Rush Medical College, Chicago, Ill; Department of Mathematics and Computer Studies, Lake Forest College, Lake Forest, Ill. 4. Department of Family Practice, Rush Medical College, Chicago, Ill. 5. Department of Pediatrics, National Jewish Health, Denver, Colo.
Abstract
BACKGROUND: Poor adherence to inhaled corticosteroids (ICS) is a critical risk factor contributing to asthma morbidity among low-income minority adolescents. OBJECTIVE: This trial tested whether peer support group meetings and peer asthma messages delivered via mp3 players improved adherence to ICS. METHODS:Low-income African American and/or Hispanic adolescents, ages 11-16 years old, with persistent asthma, and poor (≤ 48%) adherence to prescription ICS during the 3-week run-in were randomized tointervention or attention control groups (ATG) for the 10-week treatment. During treatment, the intervention arm subjects participated in weekly coping peer group support sessions and received mp3 peer-recorded asthma messages that promoted adherence. The ATG participated in weekly meetings with a research assistant and received an equivalent number of mp3 physician-recorded asthma messages. Adherence was measured by using self-report and the Doser CT, an electronic dose counter. The primary outcome was the difference in adherence at 10 weeks between the 2 arms. RESULTS:Thirty-four subjects were randomized to each arm. At 10 weeks, no statistical difference in objectively measured adherence could be detected between the 2 arms when adjusting for baseline adherence (P = .929). Adherence declined in both groups over the course of the active treatment period. In both study arms, self-reported adherence by participants was significantly higher than their objectively measured adherence at week 10 (P < .0001). CONCLUSION: Improving medication adherence in longitudinal studies is challenging. Peer support and mp3-delivered peer asthma messages may not be of sufficient dose to improve outcomes.
RCT Entities:
BACKGROUND: Poor adherence to inhaled corticosteroids (ICS) is a critical risk factor contributing to asthma morbidity among low-income minority adolescents. OBJECTIVE: This trial tested whether peer support group meetings and peer asthma messages delivered via mp3 players improved adherence to ICS. METHODS: Low-income African American and/or Hispanic adolescents, ages 11-16 years old, with persistent asthma, and poor (≤ 48%) adherence to prescription ICS during the 3-week run-in were randomized to intervention or attention control groups (ATG) for the 10-week treatment. During treatment, the intervention arm subjects participated in weekly coping peer group support sessions and received mp3 peer-recorded asthma messages that promoted adherence. The ATG participated in weekly meetings with a research assistant and received an equivalent number of mp3 physician-recorded asthma messages. Adherence was measured by using self-report and the Doser CT, an electronic dose counter. The primary outcome was the difference in adherence at 10 weeks between the 2 arms. RESULTS: Thirty-four subjects were randomized to each arm. At 10 weeks, no statistical difference in objectively measured adherence could be detected between the 2 arms when adjusting for baseline adherence (P = .929). Adherence declined in both groups over the course of the active treatment period. In both study arms, self-reported adherence by participants was significantly higher than their objectively measured adherence at week 10 (P < .0001). CONCLUSION: Improving medication adherence in longitudinal studies is challenging. Peer support and mp3-delivered peer asthma messages may not be of sufficient dose to improve outcomes.
Authors: Andrea J Apter; Ray C Boston; Maureen George; A Lorraine Norfleet; Thomas Tenhave; James C Coyne; Kathleen Birck; Susan T Reisine; Andrew J Cucchiara; Harold I Feldman Journal: J Allergy Clin Immunol Date: 2003-06 Impact factor: 10.793
Authors: Faustinus Onyirimba; Andrea Apter; Susan Reisine; Mark Litt; Corliss McCusker; MaryLou Connors; Richard ZuWallack Journal: Ann Allergy Asthma Immunol Date: 2003-04 Impact factor: 6.347
Authors: Giselle Mosnaim; Hong Li; Molly Martin; Dejuran Richardson; Paula Jo Belice; Elizabeth Avery; Norman Ryan; Bruce Bender; Lynda Powell Journal: Ann Allergy Asthma Immunol Date: 2013-12-21 Impact factor: 6.347
Authors: Rachelle R Ramsey; Jill M Plevinsky; Sophie R Kollin; Robert C Gibler; Theresa W Guilbert; Kevin A Hommel Journal: J Allergy Clin Immunol Pract Date: 2019-12-21
Authors: Alison Moore; Andrew Preece; Raj Sharma; Liam G Heaney; Richard W Costello; Robert A Wise; Andrea Ludwig-Sengpiel; Giselle Mosnaim; Jamie Rees; Ryan Tomlinson; Ruth Tal-Singer; David A Stempel; Neil Barnes Journal: Eur Respir J Date: 2021-06-04 Impact factor: 33.795