OBJECTIVES: Globally, 339 million people suffer from asthma which is one of the most common chronic diseases. The adherence to maintenance medication remains poor regardless of effective treatments such as inhaled corticosteroids (ICS). The SLR aimed to determine the influence of digital interventions to improve maintenance medication adherence in adolescent and adult patients with asthma.

METHODS: Embase, MEDLINE, CENTRAL, and Cochrane Airways were searched from database inception to June 2022 to identify randomized controlled trials (RCT) reporting percentage medication adherence with digital interventions versus non-digital control among patients with asthma (aged ≥13 years). The review followed the standard methodology for conducting reviews as per Cochrane Handbook and PRISMA guidelines. The risk of bias assessment was performed using Cochrane’s RoB-2 tool.

RESULTS: A total of 10 RCTs of 1,387 screened publications were included with sample size ranging from 23 to 6,431. The digital interventions comprised, electronic monitoring devices (n=4), interactive voice response/speech (n=3), text messages (n=2) and web-portal/application (n=1). The majority of studies included adult patients (age ≥18 years, 7 studies), while adolescent + adult (age 13-65 years) patients were assessed in three studies. The pooled results from the meta-analysis revealed a statistically significant increase in adherence to maintenance medications among the recipients of digital interventions (mean difference: 11.37%, 95% CI 5.52% to 17.22%) compared to the control group. In a subgroup analysis, electronic monitoring devices were associated with higher improvement in adherence to maintenance medications followed by text messages, interactive voice response/speech, and web portal/applications.

CONCLUSIONS: The findings demonstrated that an increase in adherence may be achieved through digital interventions in both adult and adolescent patients with asthma. Digital intervention is a novel approach to overcome the challenges associated with poor adherence to maintenance treatment and thus, reduce morbidity, mortality, and cost burden of chronic diseases like asthma.