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Discover Pediatric Collections on COVID-19 and Racism and Its Effects on Pediatric Health

American Academy of Pediatrics
Article

Sensor-Based Electronic Monitoring for Asthma: A Randomized Controlled Trial

Ruchi S. Gupta, Jamie L. Fierstein, Kathy L. Boon, Madeleine K. Kanaley, Alexandria Bozen, Kristin Kan, Deneen Vojta and Christopher M. Warren
Pediatrics January 2021, 147 (1) e20201330; DOI: https://doi.org/10.1542/peds.2020-1330
Ruchi S. Gupta
aCenter for Food Allergy and Asthma Research and Institute for Public Health and Medicine, Feinberg School of Medicine, Northwestern University, Chicago, Illinois;
bAdvanced General Pediatrics and Primary Care, Ann & Robert H. Lurie Children’s Hospital of Chicago, Chicago, Illinois;
*Contributed equally as co-first authors
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Jamie L. Fierstein
aCenter for Food Allergy and Asthma Research and Institute for Public Health and Medicine, Feinberg School of Medicine, Northwestern University, Chicago, Illinois;
*Contributed equally as co-first authors
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Kathy L. Boon
aCenter for Food Allergy and Asthma Research and Institute for Public Health and Medicine, Feinberg School of Medicine, Northwestern University, Chicago, Illinois;
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Madeleine K. Kanaley
aCenter for Food Allergy and Asthma Research and Institute for Public Health and Medicine, Feinberg School of Medicine, Northwestern University, Chicago, Illinois;
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Alexandria Bozen
aCenter for Food Allergy and Asthma Research and Institute for Public Health and Medicine, Feinberg School of Medicine, Northwestern University, Chicago, Illinois;
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Kristin Kan
aCenter for Food Allergy and Asthma Research and Institute for Public Health and Medicine, Feinberg School of Medicine, Northwestern University, Chicago, Illinois;
bAdvanced General Pediatrics and Primary Care, Ann & Robert H. Lurie Children’s Hospital of Chicago, Chicago, Illinois;
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Deneen Vojta
cUnitedHealth Group, Minnetonka, Minnesota; and
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Christopher M. Warren
aCenter for Food Allergy and Asthma Research and Institute for Public Health and Medicine, Feinberg School of Medicine, Northwestern University, Chicago, Illinois;
bAdvanced General Pediatrics and Primary Care, Ann & Robert H. Lurie Children’s Hospital of Chicago, Chicago, Illinois;
dSean N. Parker Center for Food Allergy and Asthma Research, Stanford University, Stanford, California
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Abstract

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BACKGROUND: Although sensor-based monitoring of daily inhaled corticosteroids (ICSs) and short-acting β-agonist medications may improve asthma outcomes, the effectiveness of these interventions in diverse pediatric populations remains unclear.

METHODS: Caregiver and child dyads were randomly assigned to receive inhaler sensors that allowed for caregiver and clinician electronic monitoring of medications. End points included Asthma Control Test scores (>19 indicated asthma control) and asthma health care use. Caregiver quality of life (QoL) and child ICS adherence were also assessed. Multilevel models were used to estimate adjusted changes from baseline.

RESULTS: Dyads were assigned to the control (n = 127) or intervention (n = 125) arms. At the end line, the mean Asthma Control Test score increased from 19.1 (SE = 0.3) to 21.8 (SE = 0.4) among the intervention and from 19.4 (SE = 0.3) to 19.9 (SE = 0.4) among the control (Δintervention-control = 2.2; SE = 0.6; P < .01). Adjusted rates of emergency department visits and hospitalizations among the intervention were significantly greater (incidence rate ratioemergency department = 2.2; SE = 0.5; P < .01; incidence rate ratiohospital = 3.4; SE = 1.4; P < .01) at endline than the control. Caregiver QoL was greater among the intervention at the endline (Δintervention-control = 0.3; SE = 0.2; P = .1) than the control.

CONCLUSIONS: Findings suggest that sensor-based inhaler monitoring with clinical feedback may improve asthma control and caregiver QoL within diverse populations. Higher health care use was observed among the intervention participants relative to the control, indicating further refinement is warranted.

  • Accepted October 14, 2020.
  • Copyright © 2021 by the American Academy of Pediatrics

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Pediatrics
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1 Jan 2021
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Sensor-Based Electronic Monitoring for Asthma: A Randomized Controlled Trial
Ruchi S. Gupta, Jamie L. Fierstein, Kathy L. Boon, Madeleine K. Kanaley, Alexandria Bozen, Kristin Kan, Deneen Vojta, Christopher M. Warren
Pediatrics Jan 2021, 147 (1) e20201330; DOI: 10.1542/peds.2020-1330

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Sensor-Based Electronic Monitoring for Asthma: A Randomized Controlled Trial
Ruchi S. Gupta, Jamie L. Fierstein, Kathy L. Boon, Madeleine K. Kanaley, Alexandria Bozen, Kristin Kan, Deneen Vojta, Christopher M. Warren
Pediatrics Jan 2021, 147 (1) e20201330; DOI: 10.1542/peds.2020-1330
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