Test of an Interactive Voice Response Intervention to Improve Adherence to Controller Medications in Adults with Asthma

Objective: This study was conducted to test the effectiveness of a theory-based interactive voice response (IVR) intervention to improve adherence to controller medications among adults with asthma. Methods: Fifty participants aged 18 to 65 years who had a physician diagnosis of asthma and a prescription for a daily inhaled corticosteroid, attended a baseline visit and a final visit 10 weeks later. Participants randomized to the intervention group received 2 automated IVR telephone calls separated by one month, with one additional call if they reported recent symptoms of poorly controlled disease or failure to fill a prescription. Calls were completed in less than 5 minutes and included content designed to inquire about asthma symptoms, deliver core educational messages, encourage refilling of inhaled corticosteroid prescriptions, and increase communication with providers. Adherence was tracked during 10 weeks, with objective measures that included either electronic monitors or calculation of canister weight. Participants completed the Asthma Quality of Life Questionnaire, the Asthma Control Test, and the Beliefs in Medications Questionnaire (BMQ) during both visits. Results: Adherence was 32% higher among patients in the IVR group than those in the control group (P = .003). A more favorable shift in perception of inhaled corticosteroids was seen on BMQ scores of patients in the IVR group (P = .003), which in turn correlated with degree of adherence change (r = 0.342; P = .0152). No differences emerged for the Asthma Quality of Life Questionnaire or Asthma Control Test. Conclusions: The IVR intervention resulted in a significant increase in adherence to inhaled corticosteroid treatment and improved BMQ scores during the study interval. The association of increased adherence with increased BMQ scores suggests that the intervention succeeded in helping participants adopt a more favorable perception of their controller medication, leading in turn to improved adherence. (J Am Board Fam Med 2010;23:159-165.)