Background Electronic monitoring devices with an audio-visual reminder function can significantly improve asthma inhaler adherence and control in children.¹ However, the relationship between attitudes, patterns of medication use and clinical outcomes are unknown.

Aim To examine individual patterns of inhaled corticosteroid use, and their relationships with clinical outcomes and qualitative feedback in adolescents with asthma.

Methods An exploratory study based on previous qualitative research investigating the attitudes of adolescents with asthma towards inhaler monitoring and data sharing. Patients from a specialist severe asthma clinic had their preventer inhaler use electronically monitored for one-month with a SmartTrack (Nexus6, Auckland, NZ) device. Adherence data was obtained and participants completed a questionnaire and interview at the beginning, middle and end of the trial on their attitudes. Ten months later, participants’ case notes were examined for information related to their health before and after the study.

Results Spirometric data was captured on 4/7 participants and is presented alongside adherence data in Table 1. Daily adherence ranged from 67%–93% with the largest FEV1 change (+0.95) observed in P1 who had an average daily adherence of 73%, and the smallest FEV1 change (-0.18) observed in P3 who had an average daily adherence of 93%. All changes occurred without intensification of treatment. This fits with the previous qualitative findings that participants were enthusiastic about the reminders the SmartTrack device provided and felt more conscious of adhering to their treatment plan when they knew someone would be monitoring it. Participants spoke positively for utilising the data to demonstrate their adherence to their parents or doctor.

Conclusions Through examining inhaled corticosteroid use, attitudes and clinical outcomes we gain an understanding of each patient’s condition including their habits with their inhaler (e.g. better adherence in the evenings), their attitudes to their asthma treatment and the potential effects of inhaler use on their health. Doing so helps us to identify patients who could benefit from intervention, to improve their inhaler taking behaviour and potentially improve their asthma control.

Reference 1 Chan A, Stewart AW, Harrison J, et al. The effect of an electronic monitoring device (…). Respir Med. 2015;3:210–19