BMC Med Inform Decis Mak - e-Monitoring of Asthma Therapy to Improve Compliance in children using a real-time medication monitoring system (RTMM): the e-MATIC study protocol.

Tópicos

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Resumo

CKGROUND: Many children with asthma do not have sufficient asthma control, which leads to increased healthcare costs and productivity loss of parents. One of the causative factors are adherence problems. Effective interventions improving medication adherence may therefore improve asthma control and reduce costs. A promising solution is sending real time text-messages via the mobile phone network, when a medicine is about to be forgotten. As the effect of real time text-messages in children with asthma is unknown, the primary aim of this study is to determine the effect of a Real Time Medication Monitoring system (RTMM) with text-messages on adherence to inhaled corticosteroids (ICS). The secondary objective is to study the effects of RTMM on asthma control, quality of life and cost-effectiveness of treatment.METHODS: A multicenter, randomized controlled trial involving 220 children (4-11years) using ICS for asthma. All children receive an RTMM-device for one year, which registers time and date of ICS doses. Children in the intervention group also receive tailored text-messages, sent only when a dose is at risk of omission. Primary outcome measure is the proportion of ICS dosages taken within the individually predefined time-interval. Secondary outcome measures include asthma control (monthly Asthma Control Tests), asthma exacerbations, healthcare use (collected from hospital records, patient reports and pharmacy record data), and disease-specific quality of life (PAQLQ questionnaire). Parental and children's acceptance of RTMM is evaluated with online focus groups and patient questionnaires. An economic evaluation is performed adopting a societal perspective, including relevant healthcare costs and parental productivity loss. Furthermore, a decision-analytic model is developed in which different levels of adherence are associated with clinical and financial outcomes. Also, sensitivity analyses are carried out on different price levels for RTMM.DISCUSSION: If RTMM with tailored text-message reminders proves to be effective, this technique can be used in daily practice, which would support children with suboptimal adherence in their asthma (self)management and in achieving better asthma control and better quality of life.TRIAL REGISTRATION: Netherlands Trial Register NTR2583.

Resumo Limpo

ckground mani children asthma suffici asthma control lead increas healthcar cost product loss parent one causat factor adher problem effect intervent improv medic adher may therefor improv asthma control reduc cost promis solut send real time textmessag via mobil phone network medicin forgotten effect real time textmessag children asthma unknown primari aim studi determin effect real time medic monitor system rtmm textmessag adher inhal corticosteroid ic secondari object studi effect rtmm asthma control qualiti life costeffect treatmentmethod multicent random control trial involv children year use ic asthma children receiv rtmmdevic one year regist time date ic dose children intervent group also receiv tailor textmessag sent dose risk omiss primari outcom measur proport ic dosag taken within individu predefin timeinterv secondari outcom measur includ asthma control month asthma control test asthma exacerb healthcar use collect hospit record patient report pharmaci record data diseasespecif qualiti life paqlq questionnair parent children accept rtmm evalu onlin focus group patient questionnair econom evalu perform adopt societ perspect includ relev healthcar cost parent product loss furthermor decisionanalyt model develop differ level adher associ clinic financi outcom also sensit analys carri differ price level rtmmdiscuss rtmm tailor textmessag remind prove effect techniqu can use daili practic support children suboptim adher asthma selfmanag achiev better asthma control better qualiti lifetri registr netherland trial regist ntr

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