Adherence Monitoring and E-Health: How Clinicians and Researchers Can Use Technology to Promote Inhaler Adherence for Asthma

被引:87
作者
Chan, Amy Hai Yan [1 ]
Reddel, Helen Kathryn [2 ]
Apter, Andrea [3 ]
Eakin, Michelle [4 ]
Riekert, Kristin [4 ]
Foster, Juliet Michelle [2 ]
机构
[1] Univ Auckland, Fac Med & Hlth Sci, Sch Pharm, Auckland 1, New Zealand
[2] Univ Sydney, Clin Management Grp, Woolcock Inst Med Res, Sydney, NSW 2006, Australia
[3] Univ Penn, Perelman Sch Med, Div Pulm Allergy Crit Care Med, Philadelphia, PA 19104 USA
[4] Johns Hopkins Univ, Dept Med, Div Pulm & Crit Care Med, Baltimore, MD USA
关键词
Electronic medication monitoring; Materials testing; Adherence; Asthma; AFRICAN-AMERICAN CHILDREN; INNER-CITY CHILDREN; MEDICATION ADHERENCE; CORTICOSTEROID-THERAPY; IMPROVE ADHERENCE; SINGLE INHALER; SELF-REPORT; DEVICE; FEEDBACK; PHYSICIAN;
D O I
10.1016/j.jaip.2013.06.015
中图分类号
R392 [医学免疫学];
学科分类号
100102 ;
摘要
In the past decade, rapid technological developments have advanced electronic monitoring devices (EMD) for asthma inhalers beyond simple recording of actuations to providing adherence promotion features and detailed information about patterns of medication use. This article describes currently available EMDs, discusses their utility and limitations in assessing adherence, and describes the potential for EMD-based adherence promotion interventions in clinical settings. To date, the main use of EMDs has been in clinical research. In selected populations, simple EMD-based adherence interventions, delivered either through clinician-to-patient feedback about medication use or by direct-to-patient reminders for missed doses, can significantly improve adherence. Further work is now needed to determine the impact of EMDs on clinical outcomes and their cost-effectiveness and feasibility for different clinical settings, including in disadvantaged populations. If this evidence can be provided, then the use of EMDs could expand into the management of asthma in populations with high health care costs, eg, severe asthma. In the future, medication monitoring could help distinguish poor treatment response from poor adherence, guide prescribing decisions, and prompt providers to discuss barriers to adherence; electronic health records may provide the gateway for integrating medication-use monitoring into digital chronic care management. (C) 2013 American Academy of Allergy, Asthma & Immunology
引用
收藏
页码:446 / 454
页数:9
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