Innovative monitoring of therapeutic adherence in children with persistent asthma through text messaging

Roxana Aznaran-Torres, Postgraduate School, Universidad Privada Antenor Orrego, Trujillo, Peru
Natalia Nombera-Aznaran, School of Medicine, Universidad Peruana Cayetano Heredia, Lima, Perú
Milagros Nombera-Aznaran, School of Medicine, Universidad Peruana Cayetano Heredia, Lima, Perú
Omar Aznaran-Torres, School of Electronic Engineering, Faculty of Electronic and Electrical Engineering, Universidad Nacional Mayor de San Marcos, Lima. Peru

Background: Approximately 25% of children with asthma experience uncontrolled symptoms, leading to frequent exacerbations, emergency visits, systemic corticosteroid use, unnecessary antibiotic prescription, and increased mortality risk. Poor treatment adherence is a critical factor hindering asthma control. This study aimed to implement and evaluate therapeutic adherence in children with persistent asthma through a technological solution based on short message service (SMS) reminders sent to patients’ mobile phones and receiving their responses to optimize disease management and follow-up. Method: We conducted a quasi-experimental pilot study with 28 children to develop the software RoxySMS for remotely monitoring therapeutic adherence in a tertiary hospital. Participants included caregivers of children aged 5-14 years with persistent asthma requiring daily inhaled corticosteroids alone or with long-acting beta-agonists. Caregivers needed a postpaid mobile phone for SMS communication. Outcome evaluators and data analysts were blinded to the intervention. Results: The software achieved an average response percentage of 80.8%, with individual responses ranging from 37.9% to 98.9%. On average, 50% of messages were answered immediately (5-87%), 24% within 15-60 min (2-55%), and 26% within 1-24 h (2-84%). Conclusions: RoxySMS successfully automated message delivery, validating it as a viable and cost-effective tool for monitoring adherence in chronic conditions, such as asthma, particularly in resource-limited settings.

Keywords: Asthma. Text messaging. Medication adherence. Software.