M17 PATIENT ENGAGEMENT WITH ADHERENCE TECHNOLOGY: LEARNINGS FROM THE ‘FINANCIAL INCENTIVES TO IMPROVE ASTHMA’ (FINA) STUDY

Abstract

Background Digital interventions are acceptable and often effective for improving short-term medication adherence for children and young people (CYP) with asthma. Interventions using electronic monitoring devices (EMDs) can be supported by behaviour change techniques such as reminders and financial incentives. Most digital interventions require patient engagement; however, it is important to understand how patients engage to maximise effectiveness. As part of the feasibility assessment of the FINA study, a pilot RCT of a digital financial incentives intervention, patient engagement with EMDs and smartphone app was explored. Methods During the FINA study, CYP (aged 11–17 years old) with asthma monitored their adherence for 24-weeks using an EMD. Participants randomised to financial incentives intervention viewed their adherence (table and bar-graph) and their reward progress (totaliser, traffic-light calendar, and weekly notifications) through a smartphone app. Financial reward was delivered regularly (at 4-, 8- and 12-weeks) and relied upon real-time data; participants were advised to sync their EMD and app daily. Control group viewed their sensor syncing history only and were advised to sync their EMD and app weekly. All participants were requested to promptly report any problems to the research team. Patient engagement was explored using syncing data, technical issue reporting and research team involvement. Results 32 participants are enrolled in on-going trial (intervention, n=16); 84% have completed first 12-weeks. Technical problems were experienced by 13/16 intervention and 8/16 control participants; 12 of whom did not report these until research visit 2 (12-weeks, post-intervention). 7/16 intervention participants did not sync their EMD and app as advised and were reminded by research team at least once ahead of reward delivery; 1 participant only synced once throughout intervention. 14/16 control participants did not sync weekly. Discussion Limited patient engagement with digital technology throughout this study impacted the potential for intervention efficacy; participants who were not regularly syncing regularly may not have effectively monitored their adherence/reward progress. Research team involvement was greater than anticipated. CYP focus groups will enable exploration of reasons for digital engagement/non-engagement.