Adolescent Controlled Text Messaging to Improve Asthma Medication Adherence in Primary Care

Our first aim is to determine the feasibility, acceptability and use of a low intensity text
messaging intervention to improve adherence to inhaled corticosteroid (ICS) therapy among
high risk adolescents with persistent asthma. Our second aim is to determine effect sizes of
the intervention to improve adherence (As measured by electronic monitoring and
self-report); clinical asthma control; and asthma related quality of life among adolescents
with persistent asthma. Our third and final aim is to determine the temporal relationship
between text message receipt and ICS canister actuation in order to understand mechanisms by
which text messaging may increase ICS adherence.

Inclusion Criteria:

- provider-diagnosed persistent asthma

- prescription of an ICS in accordance in NHLBI Expert Panel Report 3 guidelines for at
least 30 days prior to enrollment

- Asthma Control Test (ACT) score less than 20 (indicating lack of current control)

- no provider-diagnosed exacerbation in the 30 days prior to enrollment

- possession of a text-enabled cell phone and a plan to keep it throughout the study
period

- agreement by parents (or participants over 18 years old) to any charges levied by
their cell phone carrier for text messages associated with the study if they do not
have an unlimited texting plan

- speak and read English

Exclusion Criteria:

- another chronic lung disease (which would complicate measurement of asthma control)

- cognitive or psychiatric disorder that the treating clinician judges would impair
study participation

- use of Advair diskus for their ICS (for which no reliable electronic monitor exists)

- current enrollment in another asthma intervention study