METHODS: 40 asthma patients mean 45 yrs ( 25 F) were placed into an 3 month prospective nested study of the Asthma Adherence Pathway WebApp (AAP). Treatment (Tx) and Control (C) physicians (allergist/pulmonologists) utilized Dulera 100/200 following NHLBI guidelines. Tx and C subjects had poor asthma control at entry, defined by Asthma Control Questionnaire (ACQ) >1.0. ACQ-was measured at entry and 3 mo for Tx and C subjects. Tx subjects only 1) completed the AAAP identifying adherence barriers; 2) monitored monthly for Dulera adherence (DA) by SmartInhaler. Tx adherence was determined by the mean of 4 measures over 3-months. Tx physicians were trained in Motivational Interviewing using AAP strategies to promote DA. C subjects were not monitored for DA.
RESULTS: Treatment DA 81%. Mean baseline ACQ for Treatment (ACQ MTx=1.86, SD=0.92, N=19) and Control (ACQMC =1.59, SD=0.84, N=20) subjects did not differ. (t(37)=-0.94, p=0.35). A repeated-measures ANOVA using a within-subjects (Study Entry vs. Study End) and a between-subjects (Treatment vs. Control) factors was performed on the ACQ outcome. The time*group interaction was significant (F(1,37)=4.26, p=0.046) indicating The Tx showed greater improvement (0.75 ACQ units) than C (0.19 ACQ units). Tx had 13 subjects achieve Minimal Important Difference (defined as an improvement of greater than or equal to 0.5 units on the ACQ), compared to C 6 subjects, χ2(1)=5.76, p=.016.
CONCLUSIONS: Improvement in ACQ and high DA validates AAMM.