Adolescent Controlled Text Messaging to Improve Asthma Medication Adherence in Primary Care

Adolescent Controlled Text Messaging to Improve Asthma Medication Adherence in Primary Care.

A randomized controlled trial of a texting intervention to increase adherence to preventative asthma medication in four Cincinnati Children's Hospital Medical Center primary care clinics.

Our first aim is to determine the feasibility, acceptability and use of a low intensity text messaging intervention to improve adherence to inhaled corticosteroid (ICS) therapy among high risk adolescents with persistent asthma. Our second aim is to determine effect sizes of the intervention to improve adherence (As measured by electronic monitoring and self-report); clinical asthma control; and asthma related quality of life among adolescents with persistent asthma. Our third and final aim is to determine the temporal relationship between text message receipt and ICS canister actuation in order to understand mechanisms by which text messaging may increase ICS adherence.

Inclusion Criteria:

• provider-diagnosed persistent asthma
• prescription of an ICS in accordance in NHLBI Expert Panel Report 3 guidelines for at least 30 days prior to enrollment
• Asthma Control Test (ACT) score less than 20 (indicating lack of current control)
• no provider-diagnosed exacerbation in the 30 days prior to enrollment
• possession of a text-enabled cell phone and a plan to keep it throughout the study period
• agreement by parents (or participants over 18 years old) to any charges levied by their cell phone carrier for text messages associated with the study if they do not have an unlimited texting plan
• speak and read English

Exclusion Criteria:

• another chronic lung disease (which would complicate measurement of asthma control)
• cognitive or psychiatric disorder that the treating clinician judges would impair study participation
• use of Advair diskus for their ICS (for which no reliable electronic monitor exists)
• current enrollment in another asthma intervention study