Effectiveness of Text Message Reminders on Adherence to Inhaled Therapy in Patients With Asthma: Prospective Multicenter Randomized Clinical Trial

Carlos Almonacid; Carlos Melero; Antolín López Viña; Carolina Cisneros; Luis Pérez de Llano; Vicente Plaza; Juan Luis García-Rivero; Auxiliadora Romero Falcón; Jacinto Ramos; Teresa Bazús González; María Andrés Prado; Alfonso Muriel

doi:10.2196/12218

Effectiveness of Text Message Reminders on Adherence to Inhaled Therapy in Patients With Asthma: Prospective Multicenter Randomized Clinical Trial

JMIR Form Res. 2021 Feb 9;5(2):e12218. doi: 10.2196/12218.

Affiliations

¹ Department of Respiratory Medicine, Instituto Ramón y Cajal de Investigación Sanitaria, University of Alcala de Henares, Madrid, Spain.
² Department of Respiratory Medicine, Hospital Universitario 12 de Octubre, Institute for Health Research (i+12), Complutense University of Madrid, Madrid, Spain.
³ Department of Respiratory Medicine, Hospital Universitario Puerta de Hierro, Autonoma University of Madrid, Majadahonda, Spain.
⁴ Department of Respiratory Medicine, Hospital Universitario La Princesa, Autónoma University of Madrid, Madrid, Spain.
⁵ Department of Respiratory Medicine, Hospital Universitario Lucus Augusti, University of Lugo, Lugo, Spain.
⁶ Department of Respiratory Medicine, Hospital de la Santa Creu i Sant Pau, Institut d'Investigació Biomédica Sant Pau, Autònoma University of Barcelona, Barcelona, Spain.
⁷ Department of Respiratory Medicine, Laredo Hospital, Laredo, Spain.
⁸ Department of Respiratory Medicine, Hospital Universitario Reina Sofia, University of Cordoba, Córdoba, Spain.
⁹ Department of Respiratory Medicine, Hospital Universitario de Salamanca, University of Salamanca, Salamanca, Spain.
¹⁰ Department of Respiratory Medicine, Hospital Universitario Central de Asturias, University of Oviedo, Oviedo, Spain.
¹¹ Department of Health Information Management, Fundación Jimenez Diaz, Madrid, Spain.
¹² Unit of Clinical Biostatistics, Instituto Ramón y Cajal de Investigación Sanitaria, Consorcio Centro de Investigación Biomédica en Red de Epidemiología y Salud Pública, University of Alcala de Henares, Madrid, Spain.

PMID: 33560235
PMCID: PMC7902182
DOI: 10.2196/12218

Abstract

Background: Poor adherence to inhaled medication in asthma patients is of great concern. It is one of the main reasons for inadequate asthma control.

Objective: The goal of the research was to determine if motivational messages using short message service (SMS, or text) improved adherence to inhaled medication in patients with asthma.

Methods: A prospective multicenter randomized parallel-group clinical trial was conducted in 10 asthma clinics in Spain. Adherence was assessed with electronic monitors (Smartinhaler, Adherium Ltd) connected to inhalers. Patients in the SMS group received psychologist-developed motivational messages every 3 days for 6 months.

Results: There were 53 patients in the SMS group and 88 patients in the control group. After 6 months, mean electronic adherence was 70% (SD 17%) in the intervention group and 69% (SD 17%) in the control group (P=.82). Significant differences between the study groups in morning and evening adherence to inhaled therapy, asthma control, exhaled nitric oxide levels, or improvement of lung functions were not observed.

Conclusions: Motivational messages were not useful to improve adherence to inhaled asthma medication compared with usual care.

Keywords: SMS; Smartinhaler; adherence; asthma; cell phone; control; inhaler.

©Carlos Almonacid, Carlos Melero, Antolín López Viña, Carolina Cisneros, Luis Pérez de Llano, Vicente Plaza, Juan Luis García-Rivero, Auxiliadora Romero Falcón, Jacinto Ramos, Teresa Bazús González, María Andrés Prado, Alfonso Muriel. Originally published in JMIR Formative Research (http://formative.jmir.org), 09.02.2021.