- Design
- Pilot randomised controlled trial (FINA)
- Population
- 32 young people aged 11–17 after an ED visit for severe asthma, UK
- Primary outcome
- Inhaled corticosteroid adherence by electronic monitor
- Effect
- Median 73% vs 56% at 12 weeks (p=0.077); fell to 39% vs 32% at follow-up
FINA was a UK pilot randomised trial in 32 young people aged 11 to 17 recruited soon after an emergency attendance for severe asthma. All used an electronic inhaler monitor with twice-daily reminders; half also received £1 for each complete morning and evening dose for 12 weeks.
At 12 weeks median adherence was 73% with incentives against 56% without (p = 0.077, not significant). During follow-up, adherence fell in both groups, to 39% and 32%. Recruitment was slow and the technology unreliable.
A pilot this small cannot settle effectiveness. What it does show is how poor inhaler adherence is in teenagers after a severe attack, even with reminders, and that a short external reward did not build a lasting habit.
- Assume adherence is poor after a severe asthma attack in a teenager, and ask directly.
- Reminders alone left median adherence around 56% in the control group.
- Short-term rewards did not keep adherence up once they ended.
- Check inhaler technique and the teenager's own goals at every review.
Why it matters
The weeks after an emergency visit are high-risk, and adherence is usually lower than clinicians assume.
Don't overread it
This was a 32-person pilot that did not reach significance; it neither proves nor rules out an effect of incentives.
The statistics, in plain English
A P value of 0.077 means the difference could plausibly be chance in a sample this small. The wide ranges, from 7% to 89%, show how much individual teenagers varied.
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