Please select the eligibility criteria that correspond to the clinical trial below.
Title: 12-wks Randomised Controlled Trial to Explore the Effect of a Smartphone App. Connected to an Add-on Device System Fitted on pMDI Inhaler on Adherence to Medications Intake and Clinical Outcomes in Difficult-to-treat Asthmatic Patients
Brief Summary: The purpose of this Study is to assess the effect of a smartphone application connected to an add-on device system fitted on Pressured Metered Dose Inhaler (PMDI) on adherence to take medications as prescribed and clinical outcomes in difficult-to-treat asthmatic patients.


Options:
A: Inclusion Criteria:

* Patient's written informed consent obtained prior to any study-related procedures
* Male or female patient aged 18 years and above
* Patient with established diagnosis of asthma for at least 6 months
* Patient on maintenance therapy (Fixed dose combination ICS/LABA) with high dose of ICS
* Patient with ACT score \<20 at screening and at randomization
* Non- or ex-smoker who smoked ≤ 10 Pack-years prior to screening
* Patient must have their own Android® or iPhone operating system (IOS) smartphone
* Ability to use the pMDI device correctly

Exclusion Criteria:

* Patient with an asthma exacerbation or respiratory tract infection requiring systemic steroids and/or antibiotics within 1 to 3 month prior to screening
* Patient with a history of near-fatal asthma
* Clinically relevant and uncontrolled cardiac, hepatic, renal, gastrointestinal, endocrine, metabolic, neurologic, psychiatric or any other disorder that would put the safety of the subject at risk through participation, or which would affect the analysis
* Patient not able to be compliant with the study requirements.
* Patient with a BMI \> 40
* Patient working on night shifts
* Patient participating in the clinical phase of an interventional trial or have done so within the last 30 days prior to screening.
* Patient who has an already planned major surgery or hospitalization
* Female patient who is pregnant or lactating or who plans to become pregnant in the next 4 months.
* Patient with a history of hypersensitivity to any of the components of Foster pMDI
B: Inclusion Criteria:

1. English speakers
2. age 50 and over
3. diagnosed with one or more chronic condition(s) and
4. currently taking ﬁve or more prescribed oral medications.
5. City of Calgary resident

Exclusion Criteria:

* Patients with moderate to severe cognitive impairment
C: Inclusion Criteria:

* provider-diagnosed persistent asthma
* prescription of an ICS in accordance in NHLBI Expert Panel Report 3 guidelines for at least 30 days prior to enrollment
* Asthma Control Test (ACT) score less than 20 (indicating lack of current control)
* no provider-diagnosed exacerbation in the 30 days prior to enrollment
* possession of a text-enabled cell phone and a plan to keep it throughout the study period
* agreement by parents (or participants over 18 years old) to any charges levied by their cell phone carrier for text messages associated with the study if they do not have an unlimited texting plan
* speak and read English

Exclusion Criteria:

* another chronic lung disease (which would complicate measurement of asthma control)
* cognitive or psychiatric disorder that the treating clinician judges would impair study participation
* use of Advair diskus for their ICS (for which no reliable electronic monitor exists)
* current enrollment in another asthma intervention study
D: Inclusion Criteria:

* Doctor diagnosed asthma.
* On at least BTS stage 2, which means they will be on regular inhaled steroids.
* No change in regular asthma treatment in the last 1 month (on regular inhaled steroids, no change in steroid dose for

  1 month, no change in add on therapy in the last month).
* ACQ (Asthma Control Questionnaire) score more than or equal to 1.5.
* Can speak and understand English.

Exclusion Criteria:

* BTS stage 5 asthma (complex issues, too unstable).
* Recent changes to asthma treatment within the last month. (see above)
* ACQ (Asthma Control Questionnaire) score \< 1.5.
* Another chronic health condition (eg diabetes, congenital heart disease, cystic fibrosis).
* Can't speak or understand English.

Answer: A