Improving Asthma Outcomes in the Digital Era: A Systematic Review

Background Lack of adherence remains a major cause of poor asthma outcomes. Technology-based interventions to promote adherence to asthma controller medications are emerging. Objective This systematic review aimed to evaluate digital interventions to improve adherence to asthma controller medications and clinical outcomes. Methods Following the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines, this review identified studies using medication electronic monitoring devices (EMDs), mobile applications including smartphone applications (SPAs) or MP3 players, web-based portals, and multimodal interventions to improve asthma outcomes. Results Of the 25 interventions identified, 23 resulted in a positive outcome within the limits of the study. Two of the three EMDs, zero of the five mobile applications, zero of the 11 web portals, and three of the seven multimodal interventions showed objectively measured improvement in controller medication adherence. Conclusions Studies featuring EMD technology alone or as part of a multimodal intervention demonstrate promise in improving controller medication adherence. SPA technology both alone and in combination with other digital interventions demonstrates improvements in asthma control and quality of life. Future studies are needed to isolate the most efficacious component(s) of these interventions.