Accepted for/Published in: JMIR Research Protocols
Date Submitted: Nov 19, 2019
Date Accepted: Apr 7, 2020
Date Submitted to PubMed: May 27, 2020
Warning: This is an author submission that is not peer-reviewed or edited. Preprints - unless they show as "accepted" - should not be relied on to guide clinical practice or health-related behavior and should not be reported in news media as established information.
The Tailored Adherence Incentives for Childhood Asthma Medications (TAICAM) Trial: A Research Protocol
ABSTRACT
Background:
Poor adherence to inhaled corticosteroid (ICS) medications for children with high risk asthma is a well-documented and poorly understood problem with a disproportionate prevalence and impact on urban minority children. Financial incentives have been shown as a compelling method to engage a high-risk asthma population, but whether and how adherence can be maintained and lead to sustained high adherence trajectories is unknown.
Objective:
To determine the marginal effects of financial ICS incentives on adherence, healthcare system use, and costs in a prospective cohort of child-caregiver dyads.
Methods:
Participants will include 125 children aged 5-12 years who have had at least two hospitalizations or one hospitalization and one emergency room visit for asthma in the prior year and their caregivers. All participants will receive an electronic inhaler sensor and linked smartphone app to track medication use for 7 months. After one month of observation, participants will be randomized to one of three possible arms for a 3-month experiment. Arm 1 will receive daily text message reminders, feedback, and nominal financial incentives, arm 2 will receive daily text message reminders and feedback only, and arm 3 will receive no reminders, feedback, or incentives. All participants will then be observed for 3 months to assess for sustained effects.
Results:
Study enrollment began in August 2019. Results of the analysis is expected in February of 2022.
Conclusions:
The present study will provide data on which mobile-health intervention strategies for promoting ICS use are most efficacious in high-risk asthma patients over time. Clinical Trial: Clinicaltrial.gov NCT03907410; https://clinicaltrials.gov/ct2/show/NCT03907410
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