Determining the optimal threshold for medication adherence in adult asthma patients: An analysis of British Columbia administrative health database in Canada

BACKGROUND Mobile health (mHealth) apps have the potential to support patients’ medication use and are therefore increasingly used. Apps with broad functionality are suggested to be more effective; however, not much is known about the actual use of different functionalities and the effective engagement. OBJECTIVE The aim of this study was to explore the use and the effective engagement of adolescents (aged 12 to 18 years) with the Adolescent Adherence Patient Tool (ADAPT). METHODS The ADAPT intervention consisted of an app for patients, which was connected to a management system for their pharmacist. The aim of the ADAPT intervention was to improve medication adherence and, therefore, the app contained multiple functionalities: questionnaires to monitor symptoms and adherence, medication reminders, short movies, pharmacist chat, and peer chat. For this study, data of the ADAPT study and a cluster randomized controlled trial were used. Adolescents with asthma had 6 months’ access to the ADAPT intervention, and all app usage was securely registered in a log file. RESULTS In total, 86 adolescents (mean age 15.0, SD 2.0 years) used the ADAPT app 17 times (range 1-113) per person. Females used the app more often than males (P=.01) and for a longer period of time (P=.03). On average, 3 different functionalities were used, and 13% of the adolescents used all functionalities of the app. The questionnaires to monitor symptoms and adherence were used by most adolescents. The total app use did not affect adherence; however, activity in the pharmacist chat positively affected medication adherence (P=.03), in particular, if patients sent messages to their pharmacist (P=.01). CONCLUSIONS mHealth apps for adolescents with asthma should contain different functionalities to serve the diverging needs and preferences of individual patients. Suggested key functionalities to promote use and effectiveness in adolescents with asthma are questionnaires to monitor symptoms and a health care provider chat.

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Feasibility of individualized aerobic threshold-based exercise on ventilatory efficiency in sedentary adult asthma patients

Minerva Pneumologica ◽

10.23736/s0026-4954.18.01829-1 ◽

2019 ◽

Vol 57 (4) ◽

Author(s):

Ratko Peric ◽

Franchek M. Drobnic ◽

Julien S. Baker

Keyword(s):

Adult Asthma ◽

Ventilatory Efficiency ◽

Aerobic Threshold ◽

Asthma Patients

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Biomarkers to identify sputum eosinophilia in different adult asthma phenotypes

European Respiratory Journal ◽

10.1183/09031936.00012415 ◽

2015 ◽

Vol 46 (3) ◽

pp. 688-696 ◽

Cited By ~ 83

Author(s):

Guus A. Westerhof ◽

Daniël A. Korevaar ◽

Marijke Amelink ◽

Selma B. de Nijs ◽

Jantina C. de Groot ◽

...

Keyword(s):

Diagnostic Accuracy ◽

Operating Characteristics ◽

Total Ige ◽

Adult Asthma ◽

Asthma Phenotypes ◽

Sputum Eosinophilia ◽

Asthma Patients ◽

Outpatient Departments ◽

Nonobese Patients ◽

Blood Eosinophils

Several biomarkers have been used to assess sputum eosinophilia in asthma. It has been suggested that the diagnostic accuracy of these biomarkers might differ between asthma phenotypes. We investigated the accuracy of biomarkers in detecting sputum eosinophilia (≥3%) in different adult asthma phenotypes.Levels of eosinophils in blood and sputum, exhaled nitric oxide fraction (FeNO) and total immunoglobulin (Ig)E from 336 adult patients, enrolled in three prospective observational clinical trials and recruited at five pulmonology outpatient departments, were analysed. Areas under the receiver operating characteristics curves (AUC) for detecting sputum eosinophilia were calculated and compared between severe and mild, obese and nonobese, atopic and nonatopic and (ex-)smoking and never-smoking asthma patients.Sputum eosinophilia was present in 116 patients (35%). In the total group the AUC was 0.83 (95% CI 0.78–0.87) for blood eosinophils, 0.82 (0.77–0.87) for FeNO and 0.69 (0.63–0.75) for total IgE. AUCs were similar for blood eosinophils and FeNO between different phenotypes. Total IgE was less accurate in detecting sputum eosinophilia in atopic and obese patients than in nonatopic and nonobese patients.Blood eosinophils and FeNO had comparable diagnostic accuracy (superior to total IgE) in identifying sputum eosinophilia in adult asthma patients, irrespective of asthma phenotype such as severe, nonatopic, obese and smoking-related asthma.

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