Smartphone App improves adherence with inhaled glucocorticoids therapy in asthma children / 中国实用护理杂志

ABSTRACT

Objective To investigate the use of smartphone applications in the adherence with inhaled glucocortiocoids (ICS) therapy in asthma children. Methods Sixty-six asthma children and their caregivers in Shanghai Childrren's Medical center from July 2016 to February 2017 were recruited in this study using convenience sampling . All participants were randomly allocated to intervention and control groups. All participants were given routine education and technical guidance on inhalation. In addition all participants had the same chips attached to their regular nebulizers. The APP was installed on each caregivers' smartphone in the intervention group. Key modules of mobile applications include real-time monitoring of medication and health education. The ICS adherence rates were recorded by the chips and were monitored monthly by researcher. The frequency of asthma exacerbations, emergency department visits and hospital admissions in intervention group was collected by smartphone APP every 3 months. the frequency of asthma exacerbations, emergency department visits and hospital admissions in control group was investigated by researcher every 3 month. Results After 6 months follow up, although ICS compliance decreased in both groups. The first month's adherence in the intervention group was 98(97.0, 100.0)％, in the sixth month's was 96(92.0, 100.0)％. The first month's adherence in the control group was 93(68.5,100.0)％, in the sixth month's was 28(0, 55.5)％. The difference in adherence between the two groups was significant (Z=2.664, 4.318, P<0.01). The decline trend of the control group was significantly greater than that of the intervention group (F=25.097, P<0.01). The compliance of the control group was less than 60％from the third month and below 30％by the sixth month, below the average ICS compliance of 30％ to 60％ in China. Though the ICS compliance of intervention group was declining, the ICS compliance was more than 90％ and higher than the mean compliance in our country. No significant differences were found in the frequency of asthma exacerbations, emergency department visits and hospital admissions between the intervention and control group (χ2=3.043, 1.065, 1.015, P>0.05). But the frequency of asthma exacerbations, emergency department visits and hospital admissions of two times or more intervention group was lower than that in the control group. Conclusions Smartphone APP significantly improved the compliance of children with asthma aged 0 month to 3years old.