Rachelle R Ramsey1,2, Christina E Holbein1, Scott W Powers1,2,3, Andrew D Hershey2,3,4, Marielle A Kabbouche2,3,4, Hope L O'Brien2,3,4, Joanne Kacperski2,3,4, Jeffrey Shepard5, Kevin A Hommel1,2. 1. 1 Division of Behavioral Medicine and Clinical Psychology, Cincinnati Children's Hospital Medical Center, Cincinnati, OH, USA. 2. 2 Department of Pediatrics, University of Cincinnati College of Medicine, Cincinnati, OH, USA. 3. 3 Headache Center, Cincinnati Children's Hospital Medical Center, Cincinnati, OH, USA. 4. 4 Division of Neurology, Cincinnati Children's Hospital Medical Center, Cincinnati, OH, USA. 5. 5 MedaCheck, Cincinnati, OH USA.
Abstract
BACKGROUND: Effective management of migraine requires adherence to treatment recommendations; however, adolescents with migraine take their daily medications only 75% of the time. Low-cost adherence-focused interventions using technology may improve adherence, but have not been investigated. METHODS: Thirty-five adolescents and young adults (13-21 years) with migraine participated in an AB-design pilot study to assess the use of a mobile phone adherence-promotion application ("app") and progressive reminder system. Adherence was calculated using electronic monitoring during the baseline period and medication adherence intervention. RESULTS: Relative to baseline, adherence significantly improved during the first month of the intervention. Specifically, improvements existed for older participants with lower baseline adherence. Self-reported app-based adherence rates were significantly lower than electronically monitored adherence rates. Participants rated the intervention as acceptable and easy to use. CONCLUSIONS: "Apps" have the potential to improve medication adherence and are a promising intervention for adolescents and young adults with low adherence. Involving parents in the intervention is also helpful. Providers should assess barriers to adherence and use of technology-based interventions, encourage parents to incorporate behavioral incentives, and provide referrals for more intensive interventions to improve long-term outcomes. Further, tracking adherence in an app may result in an underestimation of adherence. Future full-scale studies should be conducted to examine adherence promotion app interventions.
BACKGROUND: Effective management of migraine requires adherence to treatment recommendations; however, adolescents with migraine take their daily medications only 75% of the time. Low-cost adherence-focused interventions using technology may improve adherence, but have not been investigated. METHODS: Thirty-five adolescents and young adults (13-21 years) with migraine participated in an AB-design pilot study to assess the use of a mobile phone adherence-promotion application ("app") and progressive reminder system. Adherence was calculated using electronic monitoring during the baseline period and medication adherence intervention. RESULTS: Relative to baseline, adherence significantly improved during the first month of the intervention. Specifically, improvements existed for older participants with lower baseline adherence. Self-reported app-based adherence rates were significantly lower than electronically monitored adherence rates. Participants rated the intervention as acceptable and easy to use. CONCLUSIONS: "Apps" have the potential to improve medication adherence and are a promising intervention for adolescents and young adults with low adherence. Involving parents in the intervention is also helpful. Providers should assess barriers to adherence and use of technology-based interventions, encourage parents to incorporate behavioral incentives, and provide referrals for more intensive interventions to improve long-term outcomes. Further, tracking adherence in an app may result in an underestimation of adherence. Future full-scale studies should be conducted to examine adherence promotion app interventions.
Entities:
Keywords:
Pediatric; adherence; headache; intervention; mHealth; mobile phone; technology
Authors: Brooke L Reidy; Scott W Powers; Christopher S Coffey; Leigh A Chamberlin; Dixie J Ecklund; Elizabeth A Klingner; Jon W Yankey; Leslie L Korbee; Linda L Porter; James Peugh; Marielle A Kabbouche; Joanne Kacperski; Andrew D Hershey Journal: J Pediatr Psychol Date: 2022-04-08
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