Feasibility of remote therapeutic monitoring to increase inhaled corticosteroid adherence in children with high-risk asthma

IF 4.7 2区医学 Q1 ALLERGY

Annals of Allergy Asthma & Immunology Pub Date : 2025-10-01 DOI:10.1016/j.anai.2025.07.016

Linda E. Mendoza DNP, CPNP, AE-C , Clarisse G. Casilang MD , Tricia Morphew MS , Jennifer Barrows PhD, RN , Paulina Schuhler MSN, RN , Stanley P. Galant MD

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引用次数: 0

Abstract

Background

Asthma can be well-controlled with the use of inhaled corticosteroids (ICS), but most children and adolescents do not adhere to recommended treatment, leading to exacerbations, emergency department visits, hospitalizations, and deaths. Remote therapeutic monitoring (RTM) has demonstrated potential to increase ICS adherence and improve asthma outcomes, but few studies have been conducted in young people, and lack of research in minority groups may contribute to health disparities.

Objective

To evaluate the feasibility of RTM in children and adolescents who receive asthma care at an urban mobile clinic serving a predominantly Hispanic population.

Methods

A total of 20 children aged 5 to 17 years participated in RTM for 6 months. Feasibility evaluation included recruitment, retention, implementation factors, and participant and provider satisfaction. ICS adherence and asthma-related outcomes were assessed monthly and analyzed descriptively.

Results

Of 24 eligible participants, 20 (83%) were recruited and 19 (95%) completed the study. Participants found RTM satisfactory with a mean rating of 4.6 of 5. Although some encountered practical challenges, 10 of 14 respondents (71%) indicated that they would continue using RTM. Providers rated their satisfaction 4 of 5, but RTM did not consistently meet patient needs, nor was it well-integrated with their workflow. Overall mean ICS adherence was 53%, and patients requiring emergency department visits decreased from 10 at baseline to 5 during the intervention.

Conclusion

RTM is feasible in underserved children with asthma, but implementation requires additional support from clinical staff. Further research is needed to determine efficacy.

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远程患者监测提高高危哮喘患儿吸入性皮质类固醇依从性的可行性

背景：使用吸入皮质类固醇（ICS）可以很好地控制哮喘，但大多数儿童和青少年不坚持推荐的治疗，导致病情加重、急诊就诊、住院和死亡。远程患者监测（RPM）已被证明具有提高ICS依从性和改善哮喘结局的潜力，但在年轻人中进行的研究很少，而且在少数群体中缺乏研究可能会导致健康差异。目的：本初步研究的目的是评估在以西班牙裔为主的城市流动诊所接受哮喘治疗的儿童和青少年RPM的可行性。方法：20名5 ~ 17岁的儿童参加为期6个月的RPM。可行性评估包括招募、保留、参与者和提供者满意度。每月评估ICS依从性和哮喘相关结果并进行描述性分析。结果：24名符合条件的参与者中有20名（83%）被招募，19名（95%）完成了研究。参与者发现RPM的平均评分为4.6分（满分5分），令人满意。虽然有些人遇到了实际的挑战，但14个受访者中有10个（71%）表示他们将继续使用RPM。提供者将他们的满意度评为4分（满分5分），但RPM并没有始终满足患者的需求，也没有很好地与他们的工作流程集成。总体平均ICS依从性为53%，需要急诊就诊的患者从基线时的10例减少到干预期间的5例。结论：RPM在服务不足的哮喘儿童中是可行的，但实施需要临床工作人员的额外支持。需要进一步的研究来确定疗效。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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来源期刊

Annals of Allergy Asthma & Immunology 医学-过敏

CiteScore

6.50

自引率

6.80%

发文量

437

审稿时长

33 days

期刊介绍： Annals of Allergy, Asthma & Immunology is a scholarly medical journal published monthly by the American College of Allergy, Asthma & Immunology. The purpose of Annals is to serve as an objective evidence-based forum for the allergy/immunology specialist to keep up to date on current clinical science (both research and practice-based) in the fields of allergy, asthma, and immunology. The emphasis of the journal will be to provide clinical and research information that is readily applicable to both the clinician and the researcher. Each issue of the Annals shall also provide opportunities to participate in accredited continuing medical education activities to enhance overall clinical proficiency.