Background: Electronic monitoring devices (EMDs) can support short-term adherence to medication. Yet, long-term evidence is absent.

Aims and objectives: Evaluate the effects of an EMD platform on medication adherence and asthma control over 12 months.

Methods: Dutch general practices were randomised to intervention or control group in this open-label cluster RCT. Non-adherent adults with uncontrolled asthma were included. Intervention patients used an EMD attached to their Symbicort® Turbuhaler® connected to the Turbu+™ Insights app to view medication use and set reminders. Inhaler use of control patients was passively measured. Primary outcome was medication adherence over 12 months. Secondary outcome was asthma control (ACQ).

Results: We randomised 136 clusters (n=164 patients, mean baseline ACQ±SD: 1.7±0.8). Mean baseline adherence and ACQ did not differ between study arms. Overall mean adherence was 69%±38.3 vs 59%±40.2 (intervention vs control). Adherence was higher in the intervention group compared to control at week 1 (OR 2.06, 95%CI 1.39-3.07), with a decline in difference over time and no significant difference at study end (OR 1.14, 95%CI 0.76-1.71, Fig 1). Asthma control was consistently better in the intervention group (OR 0.78, 95%CI 0.66-0.93).

Conclusion: Use of this EMD platform led to significant improvements in adherence and sustained improved asthma control over 12 months.