Adherium Limited, a global leader in digital health technologies that address sub-optimal medication use in chronic disease, announces the publication of results from an independent, randomized controlled trial of its respiratory disease management tool, Smartinhaler. The study, in children with poorly controlled asthma, revealed a significant reduction in hospital admissions over the course of 12 months as well as substantial other health and quality of life benefits.
The year-long STAAR study was carried out at Sheffield Children’s Hospital in the UK, led by the University of Sheffield’s Dr. Robert Morton and colleagues. Their findings were published online in the prestigious peer-reviewed medical journal Thorax this month (1). The aim of the study was to assess whether introducing digital adherence monitoring into routine practice could improve clinical outcomes in children with poorly controlled asthma.
The very positive findings from this study are welcomed in the context of the ‘Connected Asthma’ report published by Asthma UK in August 2016, which highlighted that a child is admitted to hospital every 20 minutes because of an asthma attack. It concluded that existing digital technologies should be introduced to patients to improve asthma care and that more should be done to ensure that people with asthma are able to benefit from a connected way of managing their condition (2).
77 of the 90 recruited children completed the STAAR study. 38 children were in the intervention group using Smartinhaler adherence monitoring with medication reminders and feedback in the clinic, and 39 children received usual care as part of a control group. Drug use data were collected and children’s health outcomes were assessed at each three-month follow-up.
Adherence to prescribed medication averaged 70% in the intervention group, compared to 49% in the control group (p<0.001). Patient adherence to prescribed medications is a major problem in chronic disease management. Approximately 50% of adults and children on long-term therapy for asthma fail to take medications as directed at least part of the time (3). The use of the Smartinhaler significantly increased medication adherence and this was maintained over the 12-month period. Nearly half of the children in the Smartinhaler intervention group maintained average adherence rates of >80% over the 12 months.
The adherence improvement was associated with significant reduction in asthma exacerbations – episodes of progressively worsening shortness of breath, coughing, wheezing and chest tightness – which can be life-threatening. The need for a course of oral steroids, a marker of severe exacerbations, was 53% more common in the usual care group compared to the intervention group (p=0.008). Furthermore, the hospitalization rate was five times greater in the control compared to the Smartinhaler intervention group (p<0.001). This approximates to the prevention of 12 hospitalizations in one year among the children in the intervention group, making a cost-saving argument for introducing Smartinhaler into routine practice.
Through the course of the study, the clinical benefits observed within the intervention group increased compared to the usual care group, particularly at nine and 12 months; with the intervention group requiring fewer courses of oral steroids, hospital admissions, days off school and GP/emergency department visits.
The data from the Sheffield Children’s Hospital’s study builds on a study published in January 2015 in The Lancet Respiratory Medicine (4) which showed the use of the Smartinhaler platform increased adherence to preventative medication by 180% and reduced use of reliever medication by 45%.