Tailored medication adherence incentives for high-risk children with asthma: a pilot study.
J Asthma
; 57(12): 1372-1378, 2020 12.
Article
in En
| MEDLINE
| ID: mdl-31389724
ABSTRACT
Objective:
While reminder-based electronic monitoring systems have shown promise in enhancing inhaled corticosteroid (ICS) adherence in select populations, more engaging strategies may be needed in families of children with high-risk asthma. This study assesses the acceptability and feasibility of gain-framed ICS adherence incentives in families of urban, minority children with frequent asthma hospitalization.Methods:
We enrolled children aged 5-11 years with multiple yearly asthma hospitalizations in a 2-month, mixed methods, ICS adherence incentive pilot study. All participants received inhaler sensors and a smartphone app to track ICS use. During month 1, families received daily adherence reminders and weekly feedback, and children earned up to $1/day for complete adherence. No reminders, feedback, or incentives were provided in month 2. We assessed feasibility and acceptability using caregiver surveys and semi-structured interviews and ICS adherence using electronic monitoring data.Results:
Of the 29 families approached, 20 enrolled (69%). Participants were primarily Black (95%), publicly insured (75%), and averaged 2.9 asthma hospitalizations in the prior year. Fifteen of the 16 caregivers (94%) surveyed at month 2 liked the idea of receiving adherence incentives. Mean adherence was significantly higher in month 1 compared with month 2 (80% vs. 33%, mean difference = 47%; 95% CI [33, 61], p < 0.001). Caregivers reported that their competing priorities often limited adherence, while incentives helped motivate child adherence.Conclusions:
ICS adherence incentives were acceptable and feasible in a high-risk cohort of children with asthma. Future studies should assess the efficacy of adherence incentives in enhancing ICS adherence in high-risk children.Key words
Full text:
1
Database:
MEDLINE
Main subject:
Asthma
/
Reward
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Medication Adherence
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Financing, Personal
/
Glucocorticoids
Type of study:
Etiology_studies
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Observational_studies
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Qualitative_research
/
Risk_factors_studies
Limits:
Child
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Child, preschool
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Female
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Humans
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Male
Language:
En
Journal:
J Asthma
Year:
2020
Type:
Article
Affiliation country:
United States