Impact of Electronic Medication Monitoring on Pediatric Asthma Severity and Control in a Real-World Multidisciplinary Clinic

Compared to adult asthma, the impact of electronic medication monitoring (EMM) systems on pediatric asthma outcomes has not been well described. This study assessed changes in asthma severity, control, and rescue inhaler use with EMM use in real-world, poorly controlled pediatric asthma patients. A retrospective chart review was conducted of pediatric patients with specialist-confirmed asthma utilizing a daily inhaled controller and EMM in a multidisciplinary severe asthma clinic between October 2019 and June 2021. Differences in Composite Asthma Severity Index (CASI) and Asthma Control Test (ACT) scores and rescue inhaler use were compared prior to and after 5.5 (+/- 2) months of EMM use. Paired CASI and ACT scores before and during EMM use were compared using a paired Wilcoxon signed rank-test. Twenty-six patients (mean age 11.5 years; 53.8% male; 73.1% non-Hispanic) used EMM during the study period. ACT scores significantly improved from before EMM use (median 20, IQR [18-22]) to during EMM use (median 22, IQR [20-24], p = 0.01). Rescue inhaler utilization decreased after starting EMM from a mean of 0.55 puffs/day to 0.2 puffs/day at day 75. In patients for whom data was available, there was no significant difference in CASI scores before versus during EMM use (n = 6; p = 0.42). Use of an EMM in pediatric patients as part of multidisciplinary care is associated with improvements in asthma control measures and decreased rescue inhaler use. EMM was not associated with decreased asthma severity scores, but analysis was limited by small sample size.