Young adult preferences for digital health interventions to support adherence to inhaled corticosteroids in asthma: a qualitative study

Objective: Adherence to inhaled corticosteroids (ICS) among young adults living with asthma is low and in need of appropriate intervention. Digital health interventions (DHIs) have demonstrated potential to improve ICS adherence; however, young adult preferences for these DHIs and how their use could support adherence in this population remain understudied. Therefore, this study aimed to explore young adult preferences for ICS adherence supports and potential DHI features to deliver these supports, in order to improve adherence behaviour throughout this critical developmental stage of the lifespan. Methods: Qualitative, semi-structured interviews were conducted with 13 young adults living with asthma. Analysis followed an inductive, reflexive thematic approach. Results: Participant's age ranged from 18 to 30 years (M = 24.7; 8 female). Three themes were developed from the analysis: 'Enabling young adults to find their 'own way of knowing', 'Support for making a habit of adherence', and 'Providing accessible information' which included the sub-themes: 'Education on asthma self-management and medication', 'Self-monitoring information' and 'Personal feedback on outcomes of adherence'. Suggested features to deliver these supports included a medication and prescription refill reminder, adherence charts, symptom and trigger monitoring, rewards for adherence, visual representations of lungs demonstrating the impact of adherence and lung function monitoring. Conclusion: DHIs may offer an appropriate solution to improve suboptimal adherence to ICS in young adults. However, it is crucial that young adult preferences for adherence supports and features are integrated into these interventions in order to optimise engagement and support adherence behaviour in this population.