Implementing Health Care Technology Research into Practice to Improve Adult Asthma Management

Overview

Journal J Allergy Clin Immunol Pract

Specialty Allergy & Immunology

Date 2018 Sep 12

PMID 30201160

Citations 8

Authors

Peter J Cvietusa

Glenn K Goodrich

Jo Ann Shoup

David A Steffen

Cathy Tacinas

Nicole M Wagner

Courtney B Anderson

Debra P Ritzwoller

Bruce G Bender

Affiliations

Soon will be listed here.

Abstract

Background: Use of health technology has shown potential to improve asthma adherence and outcomes. Few studies have looked at the implementation of such research within larger asthma populations.

Objective: This report examines the process of translating results from a pragmatic trial using speech recognition (SR) in children with persistent asthma into the standard operating procedure within a large health maintenance organization. Medication adherence and outcomes in adults with asthma were examined.

Methods: The SR protocol was implemented for the total Kaiser Permanente Colorado (KPCO) patient population of 480,142, of whom 36,356 had asthma. Patients had persistent asthma, filled 1 or more inhaled corticosteroid prescriptions in the prior 6 months, and remained continuously enrolled with KPCO for 2 years. Documented exacerbations included the presence of a hospitalization, emergency department visit, or course of oral corticosteroid where asthma was the principal diagnosis. Adherence and exacerbation events were compared 1 year before and 1 year after intervention for 4,510 adults aged 19 to 64.

Results: Patient adherence demonstrated a small but significant improvement from 39.5% to 41.7% (P < .0001). Although not significant, data trends suggested greater improvement for patients with lower socioeconomic status. When an outlier month was removed from both the pre- and postintervention time periods, courses of oral corticosteroids decreased. Emergency department visits and hospitalizations were infrequent in both time periods and did not decrease over time.

Conclusions: A low-cost SR intervention reminding patients to fill and take their daily controller asthma medication can improve treatment adherence and decrease the need for oral corticosteroids due to asthma exacerbations, but not decrease emergency department visits or hospitalizations.

Citing Articles

An Overview of Adherence-What It Is and Why It Is Important.

Conroy E, Banzon T, Simoneau T, Phipatanakul W, van Boven J, Larenas-Linnemann D J Allergy Clin Immunol Pract. 2024; 12(12):3180-3188.

PMID: 39074603 PMC: 11625628. DOI: 10.1016/j.jaip.2024.07.018.

Adapting adaptive design methods to accelerate adoption of a digital asthma management intervention.

Bender B, Cvietusa P, Goodrich G, King D, Shoup J Transl Behav Med. 2023; 13(3):149-155.

PMID: 36689336 PMC: 10068903. DOI: 10.1093/tbm/ibac093.

Effect of an Asthma Exacerbation on Medication Adherence.

Cvietusa P, Goodrich G, Shoup J, King D, Bender B J Allergy Clin Immunol Pract. 2022; 11(1):248-254.

PMID: 36280138 PMC: 10942659. DOI: 10.1016/j.jaip.2022.10.014.

Transition to Virtual Asthma Care During the COVID-19 Pandemic: An Observational Study.

Cvietusa P, Goodrich G, Steiner J, Shoup J, King D, Ritzwoller D J Allergy Clin Immunol Pract. 2022; 10(6):1569-1576.

PMID: 35263682 PMC: 8898589. DOI: 10.1016/j.jaip.2022.02.027.

Digital Communication Technology: Does Offering a Choice of Modality Improve Medication Adherence and Outcomes in a Persistent Asthma Population?.

Cvietusa P, Wagner N, Shoup J, Goodrich G, Shetterly S, King D Perm J. 2021; 25:1.

PMID: 33635779 PMC: 8817940. DOI: 10.7812/TPP/20.189.

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