title: Feasibility of a novel mHealth management system to capture and improve medication adherence among adolescents with asthma.
abstract: OBJECTIVE
  Currently, 7.1 million children in the United States have asthma. Nonadherence to daily controller asthma medication is common, leading to more severe symptoms, overuse of rescue medication, and increased hospitalizations. The purpose of this study was to develop and evaluate the feasibility and acceptability of a novel mHealth management system composed of a sensored device, which is connected to mobile phone app that is designed to monitor and improve asthma medication adherence.
  
  
  METHODS
  The asthma management system was designed using well-established behavioral theory. Seven adolescents aged 11-18 years were enrolled and given an adherence sensor, and four of those also received a mobile phone app with game features and reminders. Five patients completed the study, and one was lost to follow-up in each group. Mobile app users and their parents participated in focus groups to assess patient preferences. Feasibility was assessed by the ability of sensors to capture real-time medication data. Acceptability was assessed by patient questionnaire and focus group analysis.
  
  
  RESULTS
  Successful upload of real-time data from six of seven inhaler sensors to the HIPAA-compliant server demonstrates the feasibility of at-home patient monitoring using the sensor device. All three mobile app users who completed the study reported interest in continued use of the management system and would recommend the app to friends. Unstructured interviews and focus groups revealed that patients felt that the intervention helped their sense of asthma control.
  
  
  CONCLUSIONS
  This study demonstrates the feasibility of using the sensor device to remotely monitor real-time medication usage, and user feedback demonstrates the acceptability of the intervention for patient use. The findings provide guidance for the improvement of study design and technology development. Further research is needed to assess the efficacy of the intervention.
authors.affiliation: Department of Population Health Science and Policy, Icahn School of Medicine at Mount Sinai, Icahn Medical Institute; CoheroHealth, LLC.
authors.forename: Anna
authors.initials: A
authors.lastname: Cushing
authors.affiliation: Department of Population Health Science and Policy, Icahn School of Medicine at Mount Sinai, Icahn Medical Institute; CoheroHealth, LLC.
authors.forename: Melissa P
authors.initials: MP
authors.lastname: Manice
authors.affiliation: Division of Pulmonary and Critical Care, Department of Pediatrics, Icahn School of Medicine at Mount Sinai, New York, NY, USA.
authors.forename: Andrew
authors.initials: A
authors.lastname: Ting
authors.affiliation: Department of Population Health Science and Policy, Icahn School of Medicine at Mount Sinai, Icahn Medical Institute.
authors.forename: Michael K
authors.initials: MK
authors.lastname: Parides
keywords: asthma control; medication adherence; mobile health; patient engagement; patient monitoring