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Respir Med. 2017 Aug;129:39-45. doi: 10.1016/j.rmed.2017.05.013. Epub 2017 May 26.

Patient-perceived acceptability and behaviour change benefits of inhaler reminders and adherence feedback: A qualitative study.

Author information

1
Woolcock Institute of Medical Research, University of Sydney, Sydney, Australia. Electronic address: j.m.foster@woolcock.org.au.
2
Woolcock Institute of Medical Research, University of Sydney, Sydney, Australia. Electronic address: helen.reddel@sydney.edu.au.
3
Department of General Practice, Sydney Medical School - Westmead, University of Sydney, Sydney, Australia; George Institute for Global Health, Sydney, Australia. Electronic address: tim.usherwood@sydney.edu.au.
4
Centre for Adolescent Health, Royal Children's Hospital Melbourne, Melbourne, Australia; Department of Paediatrics, The University of Melbourne, Melbourne, Australia; Murdoch Childrens Research Institute, Melbourne, Australia. Electronic address: susan.sawyer@rch.org.au.
5
Faculty of Pharmacy, University of Sydney, Sydney, Australia. Electronic address: lorraine.smith@sydney.edu.au.

Abstract

INTRODUCTION:

Little is known about patients' perceptions of electronic inhaler reminders, which have emerged in recent years as adherence promotion aids. This study explored asthma patients' attitudes toward the acceptability and utility of inhaler reminders.

METHODS:

Participants from a 6-month cluster randomized controlled trial who received reminders for missed doses via SmartTrack adherence monitors (Adherium Ltd) were interviewed to explore their perceptions; interviews were audio-recorded, transcribed and analysed thematically.

RESULTS:

18 participants (50% male, mean age 39 years [range 17-68]) were interviewed. Three themes were identified. Acceptability and Feasibility: Interviewees found the monitor easy to use. For some, concerns about the monitor itself affected adherence, e.g. leaving it at home to avoid breakage. Positive features included that reminders played only for missed doses, and the choice of reminder tunes. Utility and Behavioural Impact: Interviewees described reminders as an effective "training" tool for adherence, encouraging habit-formation, behaviour change and attitude change. Reminders were considered less acceptable or useful by participants who preferred taking medication only when symptomatic or who doubted the necessity or safety of their medication. Sustainability: Some interviewees reported sustained behaviour change, supported by reminders, through the establishment of routine or via experiential learning that good adherence improved their asthma. Other interviewees wanted ongoing support (i.e. reminders or substitute adherence cues) after study end.

CONCLUSION:

Patients with asthma found 6-months' use of reminders and adherence feedback acceptable and useful for improving their adherence attitudes, adherence behaviours and confidence in asthma self-management. Some patients may benefit from ongoing adherence support.

KEYWORDS:

Ambulatory monitoring; Asthma; Behaviour change; Medication adherence; Patient satisfaction; Reinforcement

PMID:
28732834
DOI:
10.1016/j.rmed.2017.05.013
[Indexed for MEDLINE]

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