The impact of patient self-monitoring via electronic medication monitor and mobile app plus remote clinician feedback on adherence to inhaled corticosteroids: A randomized controlled trial.

Abstract Background Poor adherence to inhaled corticosteroids (ICS) and overuse of short-acting beta2-agonists (SABA) are associated with increased asthma morbidity. Objective To assess whether patient self-monitoring via electronic medication monitoring (EMM) and smartphone application plus remote clinician feedback influences ICS and SABA use. Methods Adults with uncontrolled asthma and prescribed ICS and SABA were enrolled in this 14-week study. Inhalers were fitted with EMM to track real-time usage. After a 14-day baseline, participants were randomly assigned to the treatment group where they received reminders and feedback on ICS and SABA use via a smartphone application and clinician phone calls, or control group without feedback. Linear mixed models compared the baseline percent of SABA-free days and ICS adherence to the last 14 study days. Results Participants (n=100) had a mean age of 48.5 years, 80% were female, 68% Caucasian and 80% privately insured. The percent of SABA-free days increased significantly in the treatment group (19%, 95% CI: 12, 26; P Conclusions Patient self-monitoring via a digital platform plus remote clinician feedback, maintained high baseline ICS adherence and decreased SABA use. ClinicalTrials.gov (NCT03860519).