Measuring adherence to inhaled control medication in patients with asthma: Comparison among an asthma app, patient self‐report and physician assessment
Abstract Background Previous studies have demonstrated the feasibility of using an asthma app to support medication management and adherence but failed to compare with other measures currently used in clinical practice. However, in a clinical setting, any additional adherence measurement must be eva...
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| Format: | Article |
| Language: | English |
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Wiley
2023-02-01
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| Series: | Clinical and Translational Allergy |
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| Online Access: | https://doi.org/10.1002/clt2.12210 |
| _version_ | 1797895133702651904 |
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| author | Afonso Cachim Ana Margarida Pereira Rute Almeida Rita Amaral Magna Alves‐Correia Pedro Vieira‐Marques Claudia Chaves‐Loureiro Carmelita Ribeiro Francisca Cardia Joana Gomes Carmen Vidal Eurico Silva Sara Rocha Diana Rocha Maria Luís Marques Rosália Páscoa Daniela Morais Ana Margarida Cruz Marta Santalha José Augusto Simões Sofia daSilva Diana Silva Rita Gerardo Filipa Todo Bom Ana Morete Inês Vieira Pedro Vieira Rosário Monteiro Maria Rosário Raimundo Luís Monteiro Ângela Neves Carlos Santos Ana Margarida Penas Rita Regadas José Varanda Marques Inês Rosendo Margarida Abreu Aguiar Sara Fernandes Carlos Seiça Cardoso Filipa Pimenta Patrícia Meireles Mariana Gonçalves João Almeida Fonseca Cristina Jácome |
| author_facet | Afonso Cachim Ana Margarida Pereira Rute Almeida Rita Amaral Magna Alves‐Correia Pedro Vieira‐Marques Claudia Chaves‐Loureiro Carmelita Ribeiro Francisca Cardia Joana Gomes Carmen Vidal Eurico Silva Sara Rocha Diana Rocha Maria Luís Marques Rosália Páscoa Daniela Morais Ana Margarida Cruz Marta Santalha José Augusto Simões Sofia daSilva Diana Silva Rita Gerardo Filipa Todo Bom Ana Morete Inês Vieira Pedro Vieira Rosário Monteiro Maria Rosário Raimundo Luís Monteiro Ângela Neves Carlos Santos Ana Margarida Penas Rita Regadas José Varanda Marques Inês Rosendo Margarida Abreu Aguiar Sara Fernandes Carlos Seiça Cardoso Filipa Pimenta Patrícia Meireles Mariana Gonçalves João Almeida Fonseca Cristina Jácome |
| author_sort | Afonso Cachim |
| collection | DOAJ |
| description | Abstract Background Previous studies have demonstrated the feasibility of using an asthma app to support medication management and adherence but failed to compare with other measures currently used in clinical practice. However, in a clinical setting, any additional adherence measurement must be evaluated in the context of both the patient and physician perspectives so that it can also help improve the process of shared decision making. Thus, we aimed to compare different measures of adherence to asthma control inhalers in clinical practice, namely through an app, patient self‐report and physician assessment. Methods This study is a secondary analysis of three prospective multicentre observational studies with patients (≥13 years old) with persistent asthma recruited from 61 primary and secondary care centres in Portugal. Patients were invited to use the InspirerMundi app and register their inhaled medication. Adherence was measured by the app as the number of doses taken divided by the number of doses scheduled each day and two time points were considered for analysis: 1‐week and 1‐month. At baseline, patients and physicians independently assessed adherence to asthma control inhalers during the previous week using a Visual Analogue Scale (VAS 0–100). Results A total of 193 patients (72% female; median [P25–P75] age 28 [19–41] years old) were included in the analysis. Adherence measured by the app was lower (1 week: 31 [0–71]%; 1 month: 18 [0–48]%) than patient self‐report (80 [60–95]) and physician assessment (82 [51–94]) (p < 0.001). A negligible non‐significant correlation was found between the app and subjective measurements (ρ 0.118–0.156, p > 0.05). There was a moderate correlation between patient self‐report and physician assessment (ρ = 0.596, p < 0.001). Conclusions Adherence measured by the app was lower than that reported by the patient or the physician. This was expected as objective measurements are commonly lower than subjective evaluations, which tend to overestimate adherence. Nevertheless, the low adherence measured by the app may also be influenced by the use of the app itself and this needs to be considered in future studies. |
| first_indexed | 2024-04-10T07:20:32Z |
| format | Article |
| id | doaj.art-4315ceef240842d7bc360cd665192327 |
| institution | Directory Open Access Journal |
| issn | 2045-7022 |
| language | English |
| last_indexed | 2024-04-10T07:20:32Z |
| publishDate | 2023-02-01 |
| publisher | Wiley |
| record_format | Article |
| series | Clinical and Translational Allergy |
| spelling | doaj.art-4315ceef240842d7bc360cd6651923272023-02-24T10:01:15ZengWileyClinical and Translational Allergy2045-70222023-02-01132n/an/a10.1002/clt2.12210Measuring adherence to inhaled control medication in patients with asthma: Comparison among an asthma app, patient self‐report and physician assessmentAfonso Cachim0Ana Margarida Pereira1Rute Almeida2Rita Amaral3Magna Alves‐Correia4Pedro Vieira‐Marques5Claudia Chaves‐Loureiro6Carmelita Ribeiro7Francisca Cardia8Joana Gomes9Carmen Vidal10Eurico Silva11Sara Rocha12Diana Rocha13Maria Luís Marques14Rosália Páscoa15Daniela Morais16Ana Margarida Cruz17Marta Santalha18José Augusto Simões19Sofia daSilva20Diana Silva21Rita Gerardo22Filipa Todo Bom23Ana Morete24Inês Vieira25Pedro Vieira26Rosário Monteiro27Maria Rosário Raimundo28Luís Monteiro29Ângela Neves30Carlos Santos31Ana Margarida Penas32Rita Regadas33José Varanda Marques34Inês Rosendo35Margarida Abreu Aguiar36Sara Fernandes37Carlos Seiça Cardoso38Filipa Pimenta39Patrícia Meireles40Mariana Gonçalves41João Almeida Fonseca42Cristina Jácome43Faculty of Medicine University of Porto Porto PortugalCenter for Health Technology and Services Research (CINTESIS) Faculty of Medicine University of Porto Porto PortugalCenter for Health Technology and Services Research (CINTESIS) Faculty of Medicine University of Porto Porto PortugalCenter for Health Technology and Services Research (CINTESIS) Faculty of Medicine University of Porto Porto PortugalCenter for Health Technology and Services Research (CINTESIS) Faculty of Medicine University of Porto Porto PortugalCenter for Health Technology and Services Research (CINTESIS) Faculty of Medicine University of Porto Porto PortugalPulmonology Department Hospitais da Universidade de Coimbra Centro Hospitalar e Universitário de Coimbra Coimbra PortugalServiço Imunoalergologia Centro Hospitalar e Universitário de Coimbra Coimbra PortugalUnidade de Saúde Familiar (USF) Terras de Azurara Agrupamento de Centros de Saúde Dão Lafões Mangualde PortugalServiço de Imunoalergologia, Unidade I Centro Hospitalar Vila Nova de Gaia/Espinho Vila Nova de Gaia PortugalServicio de Alergia Complejo Hospitalario Universitario de Santiago Santiago de Compostela SpainUSF João Semana Agrupamento de Centros de Saúde (ACES) Baixo Vouga Ovar PortugalUSF Arte Nova ACES Baixo Vouga Oliveirinha PortugalUSF Sá de Miranda ACES Cávado II ‐ Gerês/Cabreira Vila Verde PortugalServiço de Imunoalergologia Hospital da Senhora da Oliveira Guimarães PortugalCenter for Health Technology and Services Research (CINTESIS) Faculty of Medicine University of Porto Porto PortugalUSF Corgo ACES Douro I ‐ Marão e Douro Norte Vila Real PortugalUSF Bom Porto ACES Grande Porto V ‐ Porto Ocidental Porto PortugalServiço de Pediatria Hospital da Senhora da Oliveira Guimarães PortugalCenter for Health Technology and Services Research (CINTESIS) Faculty of Medicine University of Porto Porto PortugalUSF Cuidarte Unidade Local de Saúde do Alto Minho Portuzelo PortugalFaculty of Medicine University of Porto Porto PortugalServiço de Pneumologia Hospital Santa Marta Centro Hospitalar Universitário de Lisboa Central Lisboa PortugalServiço de Pneumologia Hospital Beatriz Ângelo Loures PortugalAllergy Unit Instituto and Hospital CUF‐Porto Porto PortugalUnidade de Cuidados Saúde Personalizados Arnaldo Sampaio ACES Pinhal Litoral Leiria PortugalUSF Mondego ACES Baixo Mondego Coimbra PortugalCenter for Health Technology and Services Research (CINTESIS) Faculty of Medicine University of Porto Porto PortugalUSF Marquês ACES Pinhal Litoral Pombal PortugalCenter for Health Technology and Services Research (CINTESIS) Faculty of Medicine University of Porto Porto PortugalUSF Araceti ACES Baixo Mondego Arazede PortugalUSF Santo António ACES Cávado III ‐ Barcelos/Esposende Barcelos PortugalUSF Baltar ACES Tâmega II ‐ Vale do Sousa Sul Baltar PortugalUSF Aquilino Ribeiro ACES Douro II ‐ Douro Sul Moimenta da Beira PortugalUSF Viseu‐Cidade ACES do Dão Lafões Viseu PortugalCenter for Health Technology and Services Research (CINTESIS) Faculty of Medicine University of Porto Porto PortugalUSF Valongo ACES Grande Porto III ‐ Maia/Valongo Valongo PortugalUCSP São João da Pesqueira ACES Douro Sul São João da Pesqueira PortugalCenter for Health Technology and Services Research (CINTESIS) Faculty of Medicine University of Porto Porto PortugalUCSP Figueira da Foz Sul ACES Baixo Mondego Lavos PortugalUSF Almedina ACES Douro II ‐ Douro Sul Lamego PortugalUSF Antonina ACES Ave/Famalicão Requião PortugalCenter for Health Technology and Services Research (CINTESIS) Faculty of Medicine University of Porto Porto PortugalCenter for Health Technology and Services Research (CINTESIS) Faculty of Medicine University of Porto Porto PortugalAbstract Background Previous studies have demonstrated the feasibility of using an asthma app to support medication management and adherence but failed to compare with other measures currently used in clinical practice. However, in a clinical setting, any additional adherence measurement must be evaluated in the context of both the patient and physician perspectives so that it can also help improve the process of shared decision making. Thus, we aimed to compare different measures of adherence to asthma control inhalers in clinical practice, namely through an app, patient self‐report and physician assessment. Methods This study is a secondary analysis of three prospective multicentre observational studies with patients (≥13 years old) with persistent asthma recruited from 61 primary and secondary care centres in Portugal. Patients were invited to use the InspirerMundi app and register their inhaled medication. Adherence was measured by the app as the number of doses taken divided by the number of doses scheduled each day and two time points were considered for analysis: 1‐week and 1‐month. At baseline, patients and physicians independently assessed adherence to asthma control inhalers during the previous week using a Visual Analogue Scale (VAS 0–100). Results A total of 193 patients (72% female; median [P25–P75] age 28 [19–41] years old) were included in the analysis. Adherence measured by the app was lower (1 week: 31 [0–71]%; 1 month: 18 [0–48]%) than patient self‐report (80 [60–95]) and physician assessment (82 [51–94]) (p < 0.001). A negligible non‐significant correlation was found between the app and subjective measurements (ρ 0.118–0.156, p > 0.05). There was a moderate correlation between patient self‐report and physician assessment (ρ = 0.596, p < 0.001). Conclusions Adherence measured by the app was lower than that reported by the patient or the physician. This was expected as objective measurements are commonly lower than subjective evaluations, which tend to overestimate adherence. Nevertheless, the low adherence measured by the app may also be influenced by the use of the app itself and this needs to be considered in future studies.https://doi.org/10.1002/clt2.12210asthmaclinical decision support systemseHealthmedication adherencemHealthmobile apps |
| spellingShingle | Afonso Cachim Ana Margarida Pereira Rute Almeida Rita Amaral Magna Alves‐Correia Pedro Vieira‐Marques Claudia Chaves‐Loureiro Carmelita Ribeiro Francisca Cardia Joana Gomes Carmen Vidal Eurico Silva Sara Rocha Diana Rocha Maria Luís Marques Rosália Páscoa Daniela Morais Ana Margarida Cruz Marta Santalha José Augusto Simões Sofia daSilva Diana Silva Rita Gerardo Filipa Todo Bom Ana Morete Inês Vieira Pedro Vieira Rosário Monteiro Maria Rosário Raimundo Luís Monteiro Ângela Neves Carlos Santos Ana Margarida Penas Rita Regadas José Varanda Marques Inês Rosendo Margarida Abreu Aguiar Sara Fernandes Carlos Seiça Cardoso Filipa Pimenta Patrícia Meireles Mariana Gonçalves João Almeida Fonseca Cristina Jácome Measuring adherence to inhaled control medication in patients with asthma: Comparison among an asthma app, patient self‐report and physician assessment Clinical and Translational Allergy asthma clinical decision support systems eHealth medication adherence mHealth mobile apps |
| title | Measuring adherence to inhaled control medication in patients with asthma: Comparison among an asthma app, patient self‐report and physician assessment |
| title_full | Measuring adherence to inhaled control medication in patients with asthma: Comparison among an asthma app, patient self‐report and physician assessment |
| title_fullStr | Measuring adherence to inhaled control medication in patients with asthma: Comparison among an asthma app, patient self‐report and physician assessment |
| title_full_unstemmed | Measuring adherence to inhaled control medication in patients with asthma: Comparison among an asthma app, patient self‐report and physician assessment |
| title_short | Measuring adherence to inhaled control medication in patients with asthma: Comparison among an asthma app, patient self‐report and physician assessment |
| title_sort | measuring adherence to inhaled control medication in patients with asthma comparison among an asthma app patient self report and physician assessment |
| topic | asthma clinical decision support systems eHealth medication adherence mHealth mobile apps |
| url | https://doi.org/10.1002/clt2.12210 |
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