Medication Adherence Was Greater In A Digital Asthma Platform Consisting Of Controller And Rescue Vs. Controller Inhalers Alone

Use of inhaler electronic medication monitors (EMMs) and mobile applications (“app”) for asthma is associated with higher controller medication adherence. The objective was to assess whether adherence was higher in patients using EMMs for both controller and rescue vs. controller inhalers alone. Patients aged ≥12 years using inhaled controller medication enrolled in a digital asthma platform (2017-2019) consisting of EMMs and an app that tracked inhaler use and provided asthma education, controller use insights and medication reminders. When used alongside rescue inhaler EMMs, the app included additional features to promote engagement, e.g. short-acting beta-agonist trends and personalized trigger identification. Patients were included if they completed an Asthma Control Test (ACT) at enrollment. Analyses included the first 90 days of EMM use. Linear mixed-effects models estimated age-adjusted associations between EMM-recorded adherence with controller only vs. controller and rescue EMM use, overall and by ACT (≤15; 16-19; ≥20). Among 5105 patients (mean age: 39 years), 57%, 22% and 21% had an ACT≤15, 16-19 and ≥20, respectively. Using both controller and rescue EMMs (vs. controller EMMs alone) was associated with 4.7% (95% CI: 2.6, 6.9; P<0.01) higher absolute percentage adherence. Improvements were greatest in patients with ACT≤15 (5.9%; 95% CI: 3.0, 8.9; P<0.01), while lower and non-significant in patients with ACT 16-19 (3.4%; 95% CI: -1.3, 8.1; P=0.15) and ACT≥20 (3.3%; 95% CI: -1.1, 7.6; P=0.13). EMM use with both rescue and controller inhalers was associated with higher adherence, suggesting that a more comprehensive digital experience of inhaler use may improve adherence.