Institute of Epidemiology & Health Care


Richelle Kosse 20.02.18

Title: Mobile health intervention increases inhaled corticosteroid adherence in adolescents with asthma

: Richelle Kosse 


Adherence rates among asthma patients are generally low, resulting in poorly controlled asthma. Adherence decreases even more during adolescence. We developed (in co-creation with patients) an interactive mobile health (mHealth) intervention; the ADolescent Adherence Patient Tool (ADAPT) containing different elements, such as questionnaires to monitor symptoms, medication alarm, educational movies, peer chat, and healthcare provider chat.


To evaluate the effect of the ADAPT intervention on inhaled corticosteroid adherence and asthma control in adolescents (12-18 year).


We conducted a cluster randomized controlled trial in 66 community pharmacies. Self-reported adherence (Medication Adherence Report Scale (MARS)), asthma control (Control of Allergic Rhinitis and Asthma Test (CARAT)), and asthma related quality of life were measured at start (t=0) and end of follow-up (t=6). We used mixed effect models to analyse the effect.


In total, 234 adolescents (147 in the control and 87 in the intervention group) completed the study (mean age 15.1±1.9 years; 52.6% females). Adherence rates of patients with low baseline adherence (N=76; MARS ≤19) increased with 1.42 points in the intervention group (N=26), whereas the rates of patients in the control group (N=50) decreased with 0.70 (intervention effect +2.12, P=0.04). This effect was larger (+2.52, P=0.02) in patients with uncontrolled asthma (CARAT ≤24) having low adherence rates (MARS ≤20). No effect was observed on asthma control or asthma related quality of life.


The ADAPT intervention increases adherence in adolescent asthma patients with poor adherence. Healthcare providers should consider a personalized mHealth approach to improve adherence in adolescents with asthma.