***TASK*** the task is to summarize an input biomedical literature in six sentences 
    ***INPUT*** the input is a biomedical literature 
    ***OUTPUT*** the output is the summary of an input biomedical literature in six sentences 
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    Input: PURPOSE To conduct a r and omized controlled pilot of a multicomponent , technology-based intervention promoting adherence to controller medication in African-American emerging adults with asthma . The intervention consisted of two computer-delivered sessions based on motivational interviewing combined with text messaged reminders between sessions . METHODS Participants ( N = 49 ) were 18 - 29 years old , African-American , with persistent asthma requiring controller medication . Participants had to report poor medication adherence and asthma control . Youth were r and omized to receive the intervention or an attention control . Data were collected through computer-delivered self-report question naires at baseline , 1 , and 3 months . Ecological Momentary Assessment via two-way text messaging was also used to collect " real-time " data on medication use and asthma control . RESULTS The intervention was feasible and acceptable to the target population , as evidence d by high retention rates and satisfaction scores . Changes in study outcomes from pre- to postintervention favored the intervention , particularly for decrease in asthma symptoms , t ( 42 ) = 2.22 , p < .05 ( Cohen 's d = .071 ) . CONCLUSIONS Results suggest that the intervention is feasible and effective . However , findings are preliminary and should be replicated with a larger sample and more sophisticated data analyses Background Many children with asthma do not have sufficient asthma control , which leads to increased healthcare costs and productivity loss of parents . One of the causative factors are adherence problems . Effective interventions improving medication adherence may therefore improve asthma control and reduce costs . A promising solution is sending real time text-messages via the mobile phone network , when a medicine is about to be forgotten . As the effect of real time text-messages in children with asthma is unknown , the primary aim of this study is to determine the effect of a Real Time Medication Monitoring system ( RTMM ) with text-messages on adherence to inhaled corticosteroids ( ICS ) . The secondary objective is to study the effects of RTMM on asthma control , quality of life and cost-effectiveness of treatment . Methods A multicenter , r and omized controlled trial involving 220 children ( 4–11 years ) using ICS for asthma . All children receive an RTMM-device for one year , which registers time and date of ICS doses . Children in the intervention group also receive tailored text-messages , sent only when a dose is at risk of omission . Primary outcome measure is the proportion of ICS dosages taken within the individually predefined time-interval . Secondary outcome measures include asthma control ( monthly Asthma Control Tests ) , asthma exacerbations , healthcare use ( collected from hospital records , patient reports and pharmacy record data ) , and disease-specific quality of life ( PAQLQ question naire ) . Parental and children ’s acceptance of RTMM is evaluated with online focus groups and patient question naires . An economic evaluation is performed adopting a societal perspective , including relevant healthcare costs and parental productivity loss . Furthermore , a decision-analytic model is developed in which different levels of adherence are associated with clinical and financial outcomes . Also , sensitivity analyses are carried out on different price levels for RTMM . Discussion If RTMM with tailored text-message reminders proves to be effective , this technique can be used in daily practice , which would support children with suboptimal adherence in their asthma (self)management and in achieving better asthma control and better quality of life . Trial registration Netherl and s Trial Register NTR2583 Background Online communities hold great potential as interventions for health , particularly for the management of chronic illness . The social support that online communities can provide has been associated with positive treatment outcomes , including medication adherence . There are few studies that have attempted to assess whether membership of an online community improves health outcomes using rigorous design s. Objective Our objective was to conduct a rigorous proof-of-concept r and omized controlled trial of an online community intervention for improving adherence to asthma medicine . Methods This 9-week intervention included a sample of asthmatic adults from the United Kingdom who were prescribed an inhaled corticosteroid preventer . Participants were recruited via email and r and omized to either an “ online community ” or “ no online community ” ( diary ) condition . After each instance of preventer use , participants ( N=216 ) were required to report the number of doses of medication taken in a short post . Those r and omized to the online community condition ( n=99 ) could read the posts of other community members , reply , and create their own posts . Participants r and omized to the  no online community condition ( n=117 ) also posted their medication use , but could not read others ’ posts . The main outcome measures were self-reported medication adherence at baseline and follow-up ( 9 weeks postbaseline ) and an objective measure of adherence to the intervention ( visits to site ) . Results In all , 103 participants completed the study ( intervention : 37.8 % , 39/99 ; control : 62.2 % , 64/117 ) . MANCOVA of self-reported adherence to asthma preventer medicine at follow-up was not significantly different between conditions in either intention-to-treat ( P=.92 ) or per- protocol ( P=.68 ) analysis . Site use was generally higher in the control compared to intervention conditions . Conclusions Joining an online community did not improve adherence to preventer medication for asthma patients . Without the encouragement of greater community support or more components to sustain engagement over time , the current findings do not support the use of an online community to improve adherence . Clinical Trial International St and ard R and omized Controlled Trial Number ( IS RCT N ) : 29399269 ; http://www.is rct n.com/IS RCT N29399269/29399269 ( Archived by WebCite at http://www.webcitation.org/6fUbEuVoT The objective of this study was to analyze data on parents ' adherence to their child 's prescribed nebulizer treatment regimen and compliance with the dem and s of the nebulizer and the face mask . Data on adherence and compliance were recorded in a 24-week double-blind , r and omized , parallel-group study with budesonide inhalation suspension in 125 young children with mild to moderate asthma .  Budesonide was administered with an Adaptive Aerosol Delivery ( AAD ) system , which recorded adherence to treatment and compliance with the AAD system . A total of 35,481 treatments were recorded and analyzed . A study question naire regarding the parents ' and children 's acceptance of the AAD system has also been analyzed . The adherence to the treatment regimen was 91.3 % , and the compliance with the AAD system was 90.4 % . True adherence , the product of adherence and compliance , was 82.5 % . Approximately 90 % of the parents found the face mask easy to seal and the AAD equipment easy to use , and over 90 % of the children accepted it within 1 week . In conclusion , the results indicate that the AAD system could be of real clinical advantage for treatment of asthma in young children OBJECTIVES To improve the asthma control and adherence to asthma preventer medication of older people using the Patient Asthma Concerns Tool ( PACT ) to identify and address unmet needs and patient concerns . METHODS Community dwelling adults over 55 years , living in Victoria or New South Wales were recruited into a single-blind , parallel design , r and omised-controlled trial comparing person-centred education including device technique , versus written information-only education .  Fifty-eight participants r and omised to the intervention group and 56 to the control completed participation . OUTCOME MEASURES asthma control , adherence to preventer medication , asthma related quality of life , asthma exacerbations and written action plan ownership were assessed at baseline , and 3 and 12 months post intervention . RESULTS Intervention participants experienced improvements in asthma control , adherence to asthma preventer medication , reduced exacerbations , improved quality of life and an increase in asthma action plan ownership at 3 and 12 months . CONCLUSION Asthma outcomes in older people can be significantly improved by delivering tailored education that identifies specific patient concerns and unmet needs . PRACTICAL IMPLICATION S Use of the PACT to identify patient concerns and unmet needs will assist health professionals to improve the health literacy of patients by addressing gaps in their knowledge and perceptions of asthma control Real-time medication monitoring ( RTMM ) is a promising tool for improving adherence to inhaled corticosteroids ( ICS ) , but has not been sufficiently tested in children with asthma . We aim ed to study the effects of RTMM with short message service ( SMS ) reminders on adherence to ICS , asthma control , asthma-specific quality of life and asthma exacerbation rate ; and to study the associated cost-effectiveness . In a multicentre , r and omised controlled trial , children ( aged 4–11 years ) using ICS were recruited from five outpatient clinics and were given an RTMM device for 12 months . The intervention group also received tailored SMS reminders , sent only when a dose was at risk of omission . Outcome measures were adherence to ICS ( RTMM data ) , asthma control ( childhood asthma control test question naire ) , quality of life ( paediatric asthma quality of life question naire ) and asthma exacerbations . Costs were calculated from a healthcare and societal perspective . We included 209 children .  Mean adherence was higher in the intervention group : 69.3 % versus 57.3 % ( difference 12.0 % , 95 % CI 6.7%–17.7 % ) . No differences were found for asthma control , quality of life or asthma exacerbations . Costs were higher in the intervention group , but this difference was not statistically significant . RTMM with tailored SMS reminders improved adherence to ICS , but not asthma control , quality of life or exacerbations in children using ICS for asthma . e-Monitoring with tailored SMS reminders improves adherence to ICS , but not clinical outcomes in children with asthma BACKGROUND Poor adherence with inhaled corticosteroids is an important problem in asthma management . Previous approaches to improving adherence have had limited success . AIM To determine whether treatment with a single inhaler containing a long-acting beta(2)-agonist and a corticosteroid for maintenance treatment and symptom relief can overcome the problem of poor adherence with inhaled corticosteroids . DESIGN OF STUDY R and omised , parallel group , open-label trial . SETTING Forty-four general practice s in Nottinghamshire . METHOD Participants who used less than 70 % of their prescribed dose of inhaled corticosteroid and had poorly controlled asthma were r and omised to budesonide 200 microg one puff twice daily plus their own short-acting beta(2)-agonist as required ( control group ) , or budesonide/formoterol 200/6 microg one puff once daily and as required ( active group ) for 6 months . The primary outcome was inhaled corticosteroid dose . RESULTS Seventy-one participants ( 35 control , 36 active group ) were r and omised . Adherence with budesonide in the control group was approximately 60 % of the prescribed dose . Participants in the active group used approximately 80 % more budesonide than participants in the control group ( 448 versus 252 microg/day , mean difference 196 mug , 95 % confidence interval 113 to 279 ; P<0.001 ) and were less likely to withdraw from the study ( 3 versus 13 ; P<0.01 ) . No safety issues were identified . CONCLUSION Using a single inhaler for both maintenance treatment and symptom relief approximately doubled the dose of inhaled corticosteroid taken , suggesting this could be a useful strategy to overcome the problems related to poor adherence with inhaled corticosteroids BACKGROUND Suboptimum adherence to preventive asthma treatment is associated with substantial morbidity and mortality , yet adherence often remains poor . We aim ed to investigate whether use of an inhaler with audiovisual reminders leads to improved adherence and asthma outcomes in school-aged children who presented to the emergency department with an asthma exacerbation . METHODS We did a r and omised controlled trial in patients aged 6 - 15 years who attended the regional emergency department in Auckl and , New Zeal and with an asthma exacerbation and were on regular inhaled corticosteroids .  Using a simple , unrestricted block r and omisation with block sizes of 200 , we r and omly assigned patients to receive an electronic monitoring device for use with their preventer inhaler with the audiovisual reminder functions either enabled to support adherence to inhaled corticosteroids ( intervention group ) or disabled ( control group ) . Participants were followed up every 2 months for 6 months . The primary outcomes were adherence to preventive inhaled corticosteroids and number of days absent from school for any reason . Asthma control was assessed as a secondary outcome . All analyses were done in the intention-to-treat population . This trial is registered with the Australian New Zeal and Clinical Trials Registry , number ACTRN12613001353785 . FINDINGS The study took place between May 10 , 2010 , and Feb 26 , 2012 . We r and omly assigned 220 patients , 110 to the intervention group and 110 to the control group .  Median percentage adherence was 84 % ( 10th percentile 5 
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Improvements in adherence were not consistently translated into observable benefit for clinical outcomes in our pooled analyses .
None of the intervention types showed clear benefit for our primary clinical outcomes - exacerbations requiring an oral corticosteroid ( OCS ) ( evidence of very low to low quality ) and asthma control ( evidence of low to moderate quality ) ; nor for our secondary outcomes - unscheduled visits ( evidence of very low to moderate quality ) and quality of life ( evidence of low to moderate quality ) .
However , some individual studies reported observed benefits for OCS and use of healthcare services .
Pooled results suggest that a variety of interventions can improve adherence .
The clinical relevance of this improvement , highlighted by uncertain and inconsistent impact on clinical outcomes such as quality of life and asthma control , is less clear .