title: e-Monitoring of Asthma Therapy to Improve Compliance in children (e-MATIC): a randomised controlled trial.
abstract: Real-time medication monitoring (RTMM) is a promising tool for improving adherence to inhaled corticosteroids (ICS), but has not been sufficiently tested in children with asthma. We aimed to study the effects of RTMM with short message service (SMS) reminders on adherence to ICS, asthma control, asthma-specific quality of life and asthma exacerbation rate; and to study the associated cost-effectiveness.In a multicentre, randomised controlled trial, children (aged 4-11 years) using ICS were recruited from five outpatient clinics and were given an RTMM device for 12 months. The intervention group also received tailored SMS reminders, sent only when a dose was at risk of omission. Outcome measures were adherence to ICS (RTMM data), asthma control (childhood asthma control test questionnaire), quality of life (paediatric asthma quality of life questionnaire) and asthma exacerbations. Costs were calculated from a healthcare and societal perspective.We included 209 children. Mean adherence was higher in the intervention group: 69.3% versus 57.3% (difference 12.0%, 95% CI 6.7%-17.7%). No differences were found for asthma control, quality of life or asthma exacerbations. Costs were higher in the intervention group, but this difference was not statistically significant.RTMM with tailored SMS reminders improved adherence to ICS, but not asthma control, quality of life or exacerbations in children using ICS for asthma.
authors.affiliation: Dept of Hospital Pharmacy, Erasmus University Medical Center, Rotterdam, The Netherlands Dept of Hospital Pharmacy, Groene Hart Ziekenhuis, Gouda, The Netherlands erwin.vasbinder@ghz.nl.
authors.forename: Erwin C
authors.initials: EC
authors.lastname: Vasbinder
authors.affiliation: Erasmus University Institute for Medical Technology Assessment, Rotterdam, The Netherlands.
authors.forename: Lucas M A
authors.initials: LM
authors.lastname: Goossens
authors.affiliation: Erasmus University Institute for Medical Technology Assessment, Rotterdam, The Netherlands.
authors.forename: Maureen P M H
authors.initials: MP
authors.lastname: Rutten-van Mölken
authors.affiliation: Dept of Hospital Pharmacy, Erasmus University Medical Center, Rotterdam, The Netherlands.
authors.forename: Brenda C M
authors.initials: BC
authors.lastname: de Winter
authors.affiliation: NIVEL, Utrecht, The Netherlands.
authors.forename: Liset
authors.initials: L
authors.lastname: van Dijk
authors.affiliation: Dept of Hospital Pharmacy, Erasmus University Medical Center, Rotterdam, The Netherlands.
authors.forename: Arnold G
authors.initials: AG
authors.lastname: Vulto
authors.affiliation: Dept of Paediatrics, BovenIJ Ziekenhuis, Amsterdam, The Netherlands.
authors.forename: Ellen I M
authors.initials: EI
authors.lastname: Blankman
authors.affiliation: Division of Paediatric Respiratory Medicine, Academic Medical Center/Emma Children's Hospital, Amsterdam, The Netherlands.
authors.forename: Nordin
authors.initials: N
authors.lastname: Dahhan
authors.affiliation: Dept of Paediatrics, Groene Hart Ziekenhuis, Gouda, The Netherlands.
authors.forename: Monique T M
authors.initials: MT
authors.lastname: Veenstra-van Schie
authors.affiliation: Dept of Paediatrics, Groene Hart Ziekenhuis, Gouda, The Netherlands.
authors.forename: Florens G A
authors.initials: FG
authors.lastname: Versteegh
authors.affiliation: Dept of Paediatrics, Sint Lucas Andreas Ziekenhuis, Amsterdam, The Netherlands.
authors.forename: Bart H M
authors.initials: BH
authors.lastname: Wolf
authors.affiliation: Division of Paediatric Respiratory Medicine, Erasmus University Medical Center/Sophia Children's Hospital, Rotterdam, The Netherlands.
authors.forename: Hettie M
authors.initials: HM
authors.lastname: Janssens
authors.affiliation: Dept of Hospital Pharmacy, Erasmus University Medical Center, Rotterdam, The Netherlands.
authors.forename: Patricia M L A
authors.initials: PM
authors.lastname: van den Bemt
mesh_terms: D000280:Administration, Inhalation; D000305:Adrenal Cortex Hormones / Q000191:economics / Q000627:therapeutic use; D018927:Anti-Asthmatic Agents / Q000191:economics / Q000627:therapeutic use*; D001249:Asthma / Q000188:drug therapy* / Q000191:economics / Q000523:psychology; D002648:Child; D002675:Child, Preschool; D003362:Cost-Benefit Analysis; D018450:Disease Progression; D016903:Drug Monitoring / Q000379:methods*; D005260:Female; D017048:Health Care Costs; D006801:Humans; D008297:Male; D055118:Medication Adherence; D010045:Outpatients; D011788:Quality of Life; D017010:Reminder Systems; D060145:Text Messaging
chemical_list: D000305:Adrenal Cortex Hormones; D018927:Anti-Asthmatic Agents