Implementation of Digital Smart Inhalers (DSI) to monitor adherence in Children and Young People (CYP) attending a difficult asthma service

Background: Poor adherence to asthma preventer medication contributes to worse asthma outcomes.

Aim: To evaluate the use of text message reminders alongside DSI’s on adherence in CYP attending the Leicester difficult asthma clinic.

Methods: Data collected from DSIs (Propeller Health) were analysed over 3 months. Asthma was confirmed objectively in all CYP >5 years. Adherence was defined as good if preventer inhaler was used as prescribed ≥75% in the previous month, or poor if <75%. Monthly text message reminders were sent to encourage usage in those with poor adherence, and congratulatory texts to those with good adherence.

Results:

50 CYP are currently enrolled with DSI’s. Median age 12 (range 4-17) years. 13 were not included in analysis (10 had <3m continuous data, 3 devices were lost/damaged).

37 CYP with ≥3m adherence data were included (fig 1). Overall, 41% of CYP were adherent throughout the 3 months, 35% were non-adherent throughout, and 13% switched from non-adherent to adherent by 3 months.

Conclusion: Simple text message reminders alongside DSIs appear to maintain or improve adherence in 54%. More follow-up data is needed to confirm if DSI monitoring can improve/maintain adherence in the longer term, and how this affects clinical outcomes.