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J Allergy Clin Immunol Pract. 2013 Sep-Oct;1(5):485-93. doi: 10.1016/j.jaip.2013.06.010. Epub 2013 Aug 30.

The impact of peer support and mp3 messaging on adherence to inhaled corticosteroids in minority adolescents with asthma: a randomized, controlled trial.

Author information

1
Department of Preventive Medicine, Rush Medical College, Chicago, Ill. Electronic address: giselle_mosnaim@rush.edu.
2
Department of Preventive Medicine, Rush Medical College, Chicago, Ill.
3
Department of Preventive Medicine, Rush Medical College, Chicago, Ill; Department of Mathematics and Computer Studies, Lake Forest College, Lake Forest, Ill.
4
Department of Family Practice, Rush Medical College, Chicago, Ill.
5
Department of Pediatrics, National Jewish Health, Denver, Colo.

Abstract

BACKGROUND:

Poor adherence to inhaled corticosteroids (ICS) is a critical risk factor contributing to asthma morbidity among low-income minority adolescents.

OBJECTIVE:

This trial tested whether peer support group meetings and peer asthma messages delivered via mp3 players improved adherence to ICS.

METHODS:

Low-income African American and/or Hispanic adolescents, ages 11-16 years old, with persistent asthma, and poor (≤ 48%) adherence to prescription ICS during the 3-week run-in were randomized to intervention or attention control groups (ATG) for the 10-week treatment. During treatment, the intervention arm subjects participated in weekly coping peer group support sessions and received mp3 peer-recorded asthma messages that promoted adherence. The ATG participated in weekly meetings with a research assistant and received an equivalent number of mp3 physician-recorded asthma messages. Adherence was measured by using self-report and the Doser CT, an electronic dose counter. The primary outcome was the difference in adherence at 10 weeks between the 2 arms.

RESULTS:

Thirty-four subjects were randomized to each arm. At 10 weeks, no statistical difference in objectively measured adherence could be detected between the 2 arms when adjusting for baseline adherence (P = .929). Adherence declined in both groups over the course of the active treatment period. In both study arms, self-reported adherence by participants was significantly higher than their objectively measured adherence at week 10 (P < .0001).

CONCLUSION:

Improving medication adherence in longitudinal studies is challenging. Peer support and mp3-delivered peer asthma messages may not be of sufficient dose to improve outcomes.

KEYWORDS:

Adolescents; Asthma knowledge; Childhood asthma; Health status disparities; Inner city; Medication adherence; Outcome assessment (health care)

PMID:
24565620
PMCID:
PMC3935180
DOI:
10.1016/j.jaip.2013.06.010
[Indexed for MEDLINE]
Free PMC Article
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