Abstract
Digital health tools can promote disease self-management, but the association of smartphone app engagement and medication adherence is unclear. We assessed the relationship between objective smartphone app engagement and controller medication use in adults with asthma and COPD. We retrospectively analyzed data from participants enrolled in a digital self-management platform for asthma and COPD. Eligible adults had a smartphone and a paired electronic medication monitor (EMM). Longitudinal, mixed-effects logistic regressions estimated the relationship between daily app engagement (app opens, session duration) and daily controller medication use. Data from 2309 participants (71% asthma; 29% COPD) was analyzed. Opening the app (vs. not opening the app) was associated with significantly greater odds (OR (95% CI)) of using controller medications in asthma (2.08 (1.98, 2.19)) and COPD (1.61 (1.49, 1.75). Longer session duration was also associated with greater odds of using controller medications in asthma and COPD, but the odds of use attenuated with longer session duration in COPD. This study presents a novel assessment of the relationship between objectively-measured smartphone app engagement and controller medication use in asthma and COPD. Such insights may help develop targeted digital health tools and interventions.
Highlights
Digital health tools can promote disease self-management, but the association of smartphone app engagement and medication adherence is unclear
There were 2309 participants included in the analysis of whom 71% (N = 1629) had selfreported asthma, and 29% (N = 663) had self-reported COPD
Over 90 days, unadjusted mean (SD) medication adherence was higher among participants with COPD than participants with asthma: 62 (32)% vs. 45 (32)%, respectively
Summary
Digital health tools can promote disease self-management, but the association of smartphone app engagement and medication adherence is unclear. We assessed the relationship between objective smartphone app engagement and controller medication use in adults with asthma and COPD. This study presents a novel assessment of the relationship between objectively-measured smartphone app engagement and controller medication use in asthma and COPD. Such insights may help develop targeted digital health tools and interventions. Use of smartphone self-management applications (“apps”) have demonstrated value in helping people with asthma and COPD improve or maintain good medication a dherence[10,11,12] especially if behavior change techniques like feedback, education and self-monitoring are integrated and address core barriers to poor adherence[13,14,15]. A systematic review of digital interventions for asthma self-management found that digital programs integrating theory-based behavioral change approaches significantly improved medication adherence compared to those that did n ot[16]
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