Improving Medication Adherence in Pediatric Asthma Patients Using an Application Based Mediation Reminder Tool

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Stride, Lee Ann
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Pediatric , Asthma , Medication , Adherence , Non-Adherence
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Abstract Purpose: The purpose of this quality improvement (QI) project is to identify patients with poorly controlled asthma due to medication nonadherence and increase medication adherence for pediatric asthma patients using a technology based smart phone application. Background: Asthma is the most prevalent chronic disease in the world. While there is no cure for asthma, with proper treatment and management the symptoms and exacerbations can be greatly reduced. Adherence to inhaled corticosteroids used to treat asthma is crucial in the prevention of complications related to asthma including multiple hospitalizations, emergency room visits, missed school days, high financial burdens on the family and economy, and morbidity and mortality. Less than half of pediatric patients prescribed inhaled corticosteroids adhere to their medication regimen. Sample/Setting: Patients aged 13-18 years old in a pediatric pulmonary clinic diagnosed with asthma who have been identified as being non-adherent to asthma medications. Methods: Patients identified as non-adherent using the Medication Adherence Report Scale for Asthma (MARS-A) were instructed on the use of a downloadable mobile phone-based application to report their daily asthma medication use. Patients would then send a report to the clinic via the application for provider review. Results: Paired samples t-tests were utilized to assess changes in MARS-A scores between the pre-implementation and post-implementation periods. The analysis revealed no significant difference in MARS-A scores (t(5) = -1.9069, p = 0.1148, Figure 1). Moreover, data indicated that five out of eight participants reported utilizing the app for over 50% of the time (62.5%, 95% CI = 28.49%-91.48%), while six out of eight participants reported using the app at all (75%, 95% CI = 34.91%-96.8%). Discussion/Conclusion: While the majority of the participants utilized the Medisafe app more than 50% of the time, there was not a significant difference in MARS-A scores pre and post-implementation. However, the limited size of the sample likely hindered the ability to identify a significant difference, with a power analysis indicating a need for at least 15 participants for an 80% chance of detecting such a difference. These findings suggest the potential benefits of a larger sample size and a longer timeframe for future investigations. Keywords: pediatric(s), asthma, medication, adherence, non-adherence, management, technology, application, electronic, reminder
Creighton University
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