Background

Asthma control is fraught with difficulties and inadequate adherence is a major cause of poor control (Levy et al., 2014). Electronic adherence monitoring methods have increased, particularly during COVID-19 (Davies et al., 2021). However, the optimal electronic method remains unclear.

Objectives

To evaluate the effectiveness of electronic methods in monitoring adherence to regular inhaled corticosteroids (ICS) alone or in combination with a long-acting ?2-agonist (LABA).

Methods

Participants

Children and adults diagnosed with asthma of any type on regular ICS alone or in combination with a LABA.

Interventions

All types of electronic adherence interventions.

Primary outcomes

Medication adherence to regular ICS alone or in combination with a LABA.

Results

Six published articles consist of 108 studies published till 2022. The adherence percentage of digital methods is 15% (MD 14.66% higher, 95% CI 7.74 to 21.57). The adherence percentage with MHhealth (MD 12% higher, 95% CI 6.22 to 18.03). However, EMDs showed most promising with a 23% (MD 23% higher, 95% CI 10.84 to 34.16), and patients were 1.50 times more likely to adhere compared to control (RR = 1.50, 95% CI 1.19?1.90) (p < 0.001). Asthma control improved for various control scales (SMD 0.31, 95% CI 0.17 to 0.44).

Conclusions

Electronic methods have shown a positive effect on adherence. EMDs appeared the most effective method. The current gaps include the heterogeneity of methods, the absence of cost-effectiveness data, and the lack of studies on severe asthma highlighting the need for further research in this field.