Trial Outcomes & Findings for Using Technology-Assisted Stepped Care Intervention to Improve Adherence in Adolescents With Asthma (NCT NCT04365556)

NCT ID: NCT04365556

Last Updated: 2025-09-18

Results Overview

The electronic monitoring system records every dose, or "puff", the patient takes and sends it to a corresponding online database that is accessible to study staff. 30 day adherence is calculated by doses taken divided by doses prescribed and is capped at 100%. Percent Change refers to the change in percent adherence at baseline compared to end of study.

Recruitment status

COMPLETED

Study phase

NA

Target enrollment

72 participants

Primary outcome timeframe

30 days

Results posted on

2025-09-18

Participant Flow

Adolescents were recruited through the CCHMC Asthma Center. Eligible adolescents were also identified through electronic medical records and approached during outpatient medical visits. Dates of recruitment: 11/19/2019 - 9/23/2023

Participant milestones

Participant milestones
Measure
TASC Intervention
Step 1 of the intervention includes educational materials related to asthma. Step 2 includes electronic monitoring of adherence and a text messaging intervention personally tailored to the participant. Step 3 includes problem solving telehealth sessions with a trained clinician. TASC Intervention: All participants receive Step 1 of the intervention. Participants who have adherence below or at 68% will step up to Step 2 or Step 3 after the third or fourth month in the study.
Treatment as Usual
Participants will not receive any intervention.
Overall Study
STARTED
37
35
Overall Study
COMPLETED
33
33
Overall Study
NOT COMPLETED
4
2

Reasons for withdrawal

Reasons for withdrawal
Measure
TASC Intervention
Step 1 of the intervention includes educational materials related to asthma. Step 2 includes electronic monitoring of adherence and a text messaging intervention personally tailored to the participant. Step 3 includes problem solving telehealth sessions with a trained clinician. TASC Intervention: All participants receive Step 1 of the intervention. Participants who have adherence below or at 68% will step up to Step 2 or Step 3 after the third or fourth month in the study.
Treatment as Usual
Participants will not receive any intervention.
Overall Study
No longer eligible due to treatment plan
1
0
Overall Study
Lost to Follow-up
3
2

Baseline Characteristics

Using Technology-Assisted Stepped Care Intervention to Improve Adherence in Adolescents With Asthma

Baseline characteristics by cohort

Baseline characteristics by cohort
Measure
TASC Intervention
n=37 Participants
Step 1 of the intervention includes educational materials related to asthma. Step 2 includes electronic monitoring of adherence and a text messaging intervention personally tailored to the participant. Step 3 includes problem solving telehealth sessions with a trained clinician. TASC Intervention: All participants receive Step 1 of the intervention. Participants who have adherence below or at 68% will step up to Step 2 or Step 3 after the third or fourth month in the study.
Treatment as Usual
n=35 Participants
Participants will not receive any intervention.
Total
n=72 Participants
Total of all reporting groups
Age, Categorical
<=18 years
37 Participants
n=5 Participants
35 Participants
n=7 Participants
72 Participants
n=5 Participants
Age, Categorical
Between 18 and 65 years
0 Participants
n=5 Participants
0 Participants
n=7 Participants
0 Participants
n=5 Participants
Age, Categorical
>=65 years
0 Participants
n=5 Participants
0 Participants
n=7 Participants
0 Participants
n=5 Participants
Age, Continuous
14.67 years
STANDARD_DEVIATION 1.84 • n=5 Participants
15.18 years
STANDARD_DEVIATION 2.15 • n=7 Participants
14.92 years
STANDARD_DEVIATION 1.99 • n=5 Participants
Sex: Female, Male
Female
22 Participants
n=5 Participants
20 Participants
n=7 Participants
42 Participants
n=5 Participants
Sex: Female, Male
Male
15 Participants
n=5 Participants
15 Participants
n=7 Participants
30 Participants
n=5 Participants
Ethnicity (NIH/OMB)
Hispanic or Latino
2 Participants
n=5 Participants
2 Participants
n=7 Participants
4 Participants
n=5 Participants
Ethnicity (NIH/OMB)
Not Hispanic or Latino
35 Participants
n=5 Participants
33 Participants
n=7 Participants
68 Participants
n=5 Participants
Ethnicity (NIH/OMB)
Unknown or Not Reported
0 Participants
n=5 Participants
0 Participants
n=7 Participants
0 Participants
n=5 Participants
Race (NIH/OMB)
American Indian or Alaska Native
0 Participants
n=5 Participants
0 Participants
n=7 Participants
0 Participants
n=5 Participants
Race (NIH/OMB)
Asian
0 Participants
n=5 Participants
0 Participants
n=7 Participants
0 Participants
n=5 Participants
Race (NIH/OMB)
Native Hawaiian or Other Pacific Islander
0 Participants
n=5 Participants
0 Participants
n=7 Participants
0 Participants
n=5 Participants
Race (NIH/OMB)
Black or African American
16 Participants
n=5 Participants
16 Participants
n=7 Participants
32 Participants
n=5 Participants
Race (NIH/OMB)
White
21 Participants
n=5 Participants
15 Participants
n=7 Participants
36 Participants
n=5 Participants
Race (NIH/OMB)
More than one race
0 Participants
n=5 Participants
4 Participants
n=7 Participants
4 Participants
n=5 Participants
Race (NIH/OMB)
Unknown or Not Reported
0 Participants
n=5 Participants
0 Participants
n=7 Participants
0 Participants
n=5 Participants
Region of Enrollment
United States
37 participants
n=5 Participants
35 participants
n=7 Participants
72 participants
n=5 Participants

PRIMARY outcome

Timeframe: 30 days

Population: Intention to treat

The electronic monitoring system records every dose, or "puff", the patient takes and sends it to a corresponding online database that is accessible to study staff. 30 day adherence is calculated by doses taken divided by doses prescribed and is capped at 100%. Percent Change refers to the change in percent adherence at baseline compared to end of study.

Outcome measures

Outcome measures
Measure
TASC Intervention
n=36 Participants
Step 1 of the intervention includes educational materials related to asthma. Step 2 includes electronic monitoring of adherence and a text messaging intervention personally tailored to the participant. Step 3 includes problem solving telehealth sessions with a trained clinician. TASC Intervention: All participants receive Step 1 of the intervention. Participants who have adherence below or at 68% will step up to Step 2 or Step 3 after the third or fourth month in the study.
Treatment as Usual
n=34 Participants
Participants will not receive any intervention.
Percent Change in Inhaler Adherence Via Electronic Monitoring
14.05 percent
Standard Deviation .30
13.43 percent
Standard Deviation .22

SECONDARY outcome

Timeframe: 2 months

Population: Intention to treat

The outcome measures the change in asthma severity (i.e., baseline, post) based on the participant's symptom burden, health care utilization, systemic corticosteroid use, and current medication use over the past month. The scale ranges from 0 to 20 with lower scores indicating less severe asthma.

Outcome measures

Outcome measures
Measure
TASC Intervention
n=37 Participants
Step 1 of the intervention includes educational materials related to asthma. Step 2 includes electronic monitoring of adherence and a text messaging intervention personally tailored to the participant. Step 3 includes problem solving telehealth sessions with a trained clinician. TASC Intervention: All participants receive Step 1 of the intervention. Participants who have adherence below or at 68% will step up to Step 2 or Step 3 after the third or fourth month in the study.
Treatment as Usual
n=34 Participants
Participants will not receive any intervention.
Change in Composite Asthma Severity Index
-0.92 score on a scale
Standard Deviation 3.09
-0.34 score on a scale
Standard Deviation 3.2

SECONDARY outcome

Timeframe: 6 months

Population: Only the TASC intervention arm completed this measure of intervention feasibility and therefore the Treatment as Usual arm is not included.

A measure of format, content, length, skills and acceptability of the intervention will be given to participants in the form of a questionnaire at the end of each step and the end of the study. The feasibility section is on a scale of 1 to 5, 1 being the worst and 5 being the best.

Outcome measures

Outcome measures
Measure
TASC Intervention
n=33 Participants
Step 1 of the intervention includes educational materials related to asthma. Step 2 includes electronic monitoring of adherence and a text messaging intervention personally tailored to the participant. Step 3 includes problem solving telehealth sessions with a trained clinician. TASC Intervention: All participants receive Step 1 of the intervention. Participants who have adherence below or at 68% will step up to Step 2 or Step 3 after the third or fourth month in the study.
Treatment as Usual
Participants will not receive any intervention.
Feasibility Questionnaire
4.30 score on a scale
Standard Deviation .50

SECONDARY outcome

Timeframe: 6 months

Population: Only the TASC intervention arm completed this measure of intervention feasibility and therefore the Treatment as Usual arm is not included.

A 10 item, Likert scale giving a global view of usability will be given to participants in the form of a questionnaire at the end of each step and at the end of the study. The scale ranges from 'Strongly Disagree' to 'Strongly Agree, with half of the items reverse scored. Scores range from 0-100 with higher scores indicating better usability.

Outcome measures

Outcome measures
Measure
TASC Intervention
n=33 Participants
Step 1 of the intervention includes educational materials related to asthma. Step 2 includes electronic monitoring of adherence and a text messaging intervention personally tailored to the participant. Step 3 includes problem solving telehealth sessions with a trained clinician. TASC Intervention: All participants receive Step 1 of the intervention. Participants who have adherence below or at 68% will step up to Step 2 or Step 3 after the third or fourth month in the study.
Treatment as Usual
Participants will not receive any intervention.
Usability: Questionnaire
75.83 score on a scale
Standard Deviation 13.57

Adverse Events

TASC Intervention

Serious events: 0 serious events
Other events: 0 other events
Deaths: 0 deaths

Treatment as Usual

Serious events: 0 serious events
Other events: 0 other events
Deaths: 0 deaths

Serious adverse events

Adverse event data not reported

Other adverse events

Adverse event data not reported

Additional Information

Rachelle Ramsey

Cincinnati Children's Hospital Medical Center

Phone: 513-803-0415

Results disclosure agreements

  • Principal investigator is a sponsor employee
  • Publication restrictions are in place