Ruchi S Gupta1,2,3, Jamie L Fierstein4,3, Kathy L Boon4, Madeleine K Kanaley4, Alexandria Bozen4, Kristin Kan4,2, Deneen Vojta5, Christopher M Warren4,2,6. 1. Center for Food Allergy and Asthma Research and Institute for Public Health and Medicine, Feinberg School of Medicine, Northwestern University, Chicago, Illinois; r-gupta@northwestern.edu. 2. Advanced General Pediatrics and Primary Care, Ann & Robert H. Lurie Children's Hospital of Chicago, Chicago, Illinois. 3. Contributed equally as co-first authors. 4. Center for Food Allergy and Asthma Research and Institute for Public Health and Medicine, Feinberg School of Medicine, Northwestern University, Chicago, Illinois. 5. UnitedHealth Group, Minnetonka, Minnesota; and. 6. Sean N. Parker Center for Food Allergy and Asthma Research, Stanford University, Stanford, California.
Abstract
BACKGROUND: Although sensor-based monitoring of daily inhaled corticosteroids (ICSs) and short-acting β-agonist medications may improve asthma outcomes, the effectiveness of these interventions in diverse pediatric populations remains unclear. METHODS: Caregiver and child dyads were randomly assigned to receive inhaler sensors that allowed for caregiver and clinician electronic monitoring of medications. End points included Asthma Control Test scores (≥19 indicated asthma control) and asthma health care use. Caregiver quality of life (QoL) and child ICS adherence were also assessed. Multilevel models were used to estimate adjusted changes from baseline. RESULTS: Dyads were assigned to the control (n = 127) or intervention (n = 125) arms. At the end line, the mean Asthma Control Test score increased from 19.1 (SE = 0.3) to 21.8 (SE = 0.4) among the intervention and from 19.4 (SE = 0.3) to 19.9 (SE = 0.4) among the control (Δintervention-control = 2.2; SE = 0.6; P < .01). Adjusted rates of emergency department visits and hospitalizations among the intervention were significantly greater (incidence rate ratioemergency department = 2.2; SE = 0.5; P < .01; incidence rate ratiohospital = 3.4; SE = 1.4; P < .01) at endline than the control. Caregiver QoL was greater among the intervention at the endline (Δintervention-control = 0.3; SE = 0.2; P = .1) than the control. CONCLUSIONS: Findings suggest that sensor-based inhaler monitoring with clinical feedback may improve asthma control and caregiver QoL within diverse populations. Higher health care use was observed among the intervention participants relative to the control, indicating further refinement is warranted.
BACKGROUND: Although sensor-based monitoring of daily inhaled corticosteroids (ICSs) and short-acting β-agonist medications may improve asthma outcomes, the effectiveness of these interventions in diverse pediatric populations remains unclear. METHODS: Caregiver and child dyads were randomly assigned to receive inhaler sensors that allowed for caregiver and clinician electronic monitoring of medications. End points included Asthma Control Test scores (≥19 indicated asthma control) and asthma health care use. Caregiver quality of life (QoL) and child ICS adherence were also assessed. Multilevel models were used to estimate adjusted changes from baseline. RESULTS: Dyads were assigned to the control (n = 127) or intervention (n = 125) arms. At the end line, the mean Asthma Control Test score increased from 19.1 (SE = 0.3) to 21.8 (SE = 0.4) among the intervention and from 19.4 (SE = 0.3) to 19.9 (SE = 0.4) among the control (Δintervention-control = 2.2; SE = 0.6; P < .01). Adjusted rates of emergency department visits and hospitalizations among the intervention were significantly greater (incidence rate ratioemergency department = 2.2; SE = 0.5; P < .01; incidence rate ratiohospital = 3.4; SE = 1.4; P < .01) at endline than the control. Caregiver QoL was greater among the intervention at the endline (Δintervention-control = 0.3; SE = 0.2; P = .1) than the control. CONCLUSIONS: Findings suggest that sensor-based inhaler monitoring with clinical feedback may improve asthma control and caregiver QoL within diverse populations. Higher health care use was observed among the intervention participants relative to the control, indicating further refinement is warranted.
Authors: Kelly A McNally; Jennifer Rohan; Mark Schluchter; Kristin A Riekert; Pamela Vavrek; Amy Schmidt; Susan Redline; Carolyn Kercsmar; Dennis Drotar Journal: J Asthma Date: 2009-11 Impact factor: 2.515
Authors: Harris S Silver; Christopher M Blanchette; Shital Kamble; Hans Petersen; Matthew A Letter; David Meddis; Benjamin Gutierrez Journal: Am J Manag Care Date: 2011-01 Impact factor: 2.229
Authors: Shahid I Sheikh; Judy Pitts; Nancy A Ryan-Wenger; Kavitha Kotha; Karen S McCoy; David R Stukus Journal: J Asthma Date: 2016-11-10 Impact factor: 2.515
Authors: Jennifer Rohan; Dennis Drotar; Kelly McNally; Mark Schluchter; Kristin Riekert; Pamela Vavrek; Amy Schmidt; Susan Redline; Carolyn Kercsmar Journal: J Pediatr Psychol Date: 2009-08-26
Authors: Robert A Nathan; Christine A Sorkness; Mark Kosinski; Michael Schatz; James T Li; Philip Marcus; John J Murray; Trudy B Pendergraft Journal: J Allergy Clin Immunol Date: 2004-01 Impact factor: 10.793
Authors: Amy Chan; Anna De Simoni; Vari Wileman; Lois Holliday; Chris J Newby; Claudia Chisari; Sana Ali; Natalee Zhu; Prathima Padakanti; Vasita Pinprachanan; Victoria Ting; Chris J Griffiths Journal: Cochrane Database Syst Rev Date: 2022-06-13