Electronic adherence monitoring device performance and patient acceptability: a randomized control trial

<p><b>Background</b>: To investigate the performance and patient acceptability of an inhaler electronic monitoring device in a real-world childhood asthma population.</p> <p><b>Methods</b>: Children 6 to 15 years presenting with asthma to the hospital emergency department and prescribed inhaled corticosteroids were included. Participants were randomized to receive a device with reminder features enabled or disabled for use with their preventer. Device quality control tests were conducted. Questionnaires on device acceptability, utility and ergonomics were completed at six months.</p> <p><b>Results</b>: A total of 1306 quality control tests were conducted; 84% passed pre-issue and 87% return testing. The most common failure reason was actuation under-recording. Acceptability scores were high, with higher scores in the reminder than non-reminder group (median, 5^th-95^th percentile: 4.1, 3.1–5.0 versus 3.7, 2.3–4.8; p < 0.001). Most (>90%) rated the device easy to use. Feedback was positive across five themes: device acceptability, ringtone acceptability, suggestions for improvement, effect on medication use, and effect on asthma control.</p> <p><b>Conclusions</b>: This study investigates electronic monitoring device performance and acceptability in children using quantitative and qualitative measures. Results indicate satisfactory reliability, although failure rates of 13–16% indicate the importance of quality control. Favorable acceptability ratings support the use of these devices in children.