Non-response to Communication Technology Outreach for Beta-agonist Overuse in a Pragmatic Randomized Trial of Patients with Asthma

Excerpt

Evidence suggests that communication technology applications can improve treatment adherence.1 However, a recent Cochrane Review concluded insufficient evidence exists to determine the effects of automated communication on managing chronic conditions such as asthma.2 Because not all patients are receptive to communication technology interventions, defining factors associated with non-response to electronic outreach can inform tailoring future interventions to increase effectiveness. As part of a pragmatic trial targeting asthma patients with too frequent refills of inhaled beta-agonists (“overfill”),3 the objective of this work was to describe and compare patients who did versus did not respond to a communication technology outreach. A higher asthma medication ratio (AMR), defined as the ratio of asthma controller medications (numerator, e.g., inhaled corticosteroids) to total controller medications plus inhaled beta-agonists (denominator), is associated with better asthma outcomes.4 We hypothesized that patients who did not respond to outreach would have a lower AMR than patients who did respond. …