Monitoring Adherence to Asthma Inhalers Using the InspirerMundi App: Analysis of Real-World, Medium-Term Feasibility Studies
Background: Poor medication adherence is a major challenge in asthma and objective assessment of inhaler adherence is needed. InspirerMundi app aims to monitor inhaler adherence while turning it into a positive experience through gamification and social support.Objective: We assessed the medium-term...
| Main Authors: | , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , |
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| Format: | Article |
| Language: | English |
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Frontiers Media S.A.
2021-07-01
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| Series: | Frontiers in Medical Technology |
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| Online Access: | https://www.frontiersin.org/articles/10.3389/fmedt.2021.649506/full |
| _version_ | 1818654826982014976 |
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| author | Cristina Jácome Cristina Jácome Rute Almeida Rute Almeida Ana Margarida Pereira Ana Margarida Pereira Ana Margarida Pereira Rita Amaral Rita Amaral Rita Amaral Rita Amaral Pedro Vieira-Marques Sandra Mendes Magna Alves-Correia José Alberto Ferreira Inês Lopes Joana Gomes Luís Araújo Mariana Couto Cláudia Chaves Loureiro Lilia Maia Santos Ana Arrobas Margarida Valério Ana Todo Bom João Azevedo Maria Fernanda Teixeira Manuel Ferreira-Magalhães Manuel Ferreira-Magalhães Manuel Ferreira-Magalhães Paula Leiria Pinto Nicole Pinto Ana Castro Neves Ana Morête Filipa Todo Bom Alberto Costa Diana Silva Maria João Vasconcelos Helena Falcão Maria Luís Marques Ana Mendes João Cardoso José Carlos Cidrais Rodrigues Georgeta Oliveira Joana Carvalho Carlos Lozoya Natacha Santos Fernando Menezes Ricardo Gomes Rita Câmara Rodrigo Rodrigues Alves Ana Sofia Moreira Carmo Abreu Rui Silva Diana Bordalo Diana Bordalo Carlos Alves Cristina Lopes Cristina Lopes Luís Taborda-Barata Luís Taborda-Barata Ricardo M. Fernandes Rosário Ferreira Carla Chaves-Loureiro Maria José Cálix Adelaide Alves João Almeida Fonseca João Almeida Fonseca João Almeida Fonseca João Almeida Fonseca |
| author_facet | Cristina Jácome Cristina Jácome Rute Almeida Rute Almeida Ana Margarida Pereira Ana Margarida Pereira Ana Margarida Pereira Rita Amaral Rita Amaral Rita Amaral Rita Amaral Pedro Vieira-Marques Sandra Mendes Magna Alves-Correia José Alberto Ferreira Inês Lopes Joana Gomes Luís Araújo Mariana Couto Cláudia Chaves Loureiro Lilia Maia Santos Ana Arrobas Margarida Valério Ana Todo Bom João Azevedo Maria Fernanda Teixeira Manuel Ferreira-Magalhães Manuel Ferreira-Magalhães Manuel Ferreira-Magalhães Paula Leiria Pinto Nicole Pinto Ana Castro Neves Ana Morête Filipa Todo Bom Alberto Costa Diana Silva Maria João Vasconcelos Helena Falcão Maria Luís Marques Ana Mendes João Cardoso José Carlos Cidrais Rodrigues Georgeta Oliveira Joana Carvalho Carlos Lozoya Natacha Santos Fernando Menezes Ricardo Gomes Rita Câmara Rodrigo Rodrigues Alves Ana Sofia Moreira Carmo Abreu Rui Silva Diana Bordalo Diana Bordalo Carlos Alves Cristina Lopes Cristina Lopes Luís Taborda-Barata Luís Taborda-Barata Ricardo M. Fernandes Rosário Ferreira Carla Chaves-Loureiro Maria José Cálix Adelaide Alves João Almeida Fonseca João Almeida Fonseca João Almeida Fonseca João Almeida Fonseca |
| author_sort | Cristina Jácome |
| collection | DOAJ |
| description | Background: Poor medication adherence is a major challenge in asthma and objective assessment of inhaler adherence is needed. InspirerMundi app aims to monitor inhaler adherence while turning it into a positive experience through gamification and social support.Objective: We assessed the medium-term feasibility of the InspirerMundi app to monitor inhaler adherence in real-world patients with persistent asthma (treated with daily inhaled medication). In addition, we attempted to identify the characteristics of the patients related to higher app use.Methods: Two real-world multicenter observational studies, with one initial face-to-face visit and a 4-month telephone interview, were conducted in 29 secondary care centers from Portugal. During an initial face-to-face visit, patients were invited to use the app daily to register their asthma medication intakes. A scheduled intake was considered taken when patients took a photo of the medication (inhaler, blister, or others) using the image-based medication detection tool. Medication adherence was calculated as the number of doses taken as a percentage of the number scheduled. Interacting with the app ≥30 days was used as the cut-off for higher app use.Results: A total of 114 patients {median 20 [percentile 25 to percentile 75 (P25–P75) 16–36] years, 62% adults} were invited, 107 (94%) installed the app and 83 (73%) completed the 4-month interview. Patients interacted with the app for a median of 18 [3–45] days, translated on a median use rate of 15 [3–38]%. Median inhaler adherence assessed through the app was 34 [4–73]% when considering all scheduled inhalations for the study period. Inhaler adherence assessed was not significantly correlated with self-reported estimates. Median adherence for oral and other medication was 41 [6–83]% and 43 [3–73]%, respectively. Patients with higher app use were slightly older (p = 0.012), more frequently taking medication for other health conditions (p = 0.040), and more frequently prescribed long-acting muscarinic antagonists (LAMA, p = 0.024). After 4 months, Control of Allergic Rhinitis and Asthma Test (CARAT) scores improved (p < 0.001), but no differences between patients interacting with the app for 30 days or less were seen.Conclusions: The InspirerMundi app was feasible to monitor inhaler adherence in patients with persistent asthma. The persistent use of this mHealth technology varies widely. A better understanding of characteristics related to higher app use is still needed before effectiveness studies are undertaken. |
| first_indexed | 2024-12-17T02:59:58Z |
| format | Article |
| id | doaj.art-f6efa89149994c92b313a51e6e434762 |
| institution | Directory Open Access Journal |
| issn | 2673-3129 |
| language | English |
| last_indexed | 2024-12-17T02:59:58Z |
| publishDate | 2021-07-01 |
| publisher | Frontiers Media S.A. |
| record_format | Article |
| series | Frontiers in Medical Technology |
| spelling | doaj.art-f6efa89149994c92b313a51e6e4347622022-12-21T22:06:07ZengFrontiers Media S.A.Frontiers in Medical Technology2673-31292021-07-01310.3389/fmedt.2021.649506649506Monitoring Adherence to Asthma Inhalers Using the InspirerMundi App: Analysis of Real-World, Medium-Term Feasibility StudiesCristina Jácome0Cristina Jácome1Rute Almeida2Rute Almeida3Ana Margarida Pereira4Ana Margarida Pereira5Ana Margarida Pereira6Rita Amaral7Rita Amaral8Rita Amaral9Rita Amaral10Pedro Vieira-Marques11Sandra Mendes12Magna Alves-Correia13José Alberto Ferreira14Inês Lopes15Joana Gomes16Luís Araújo17Mariana Couto18Cláudia Chaves Loureiro19Lilia Maia Santos20Ana Arrobas21Margarida Valério22Ana Todo Bom23João Azevedo24Maria Fernanda Teixeira25Manuel Ferreira-Magalhães26Manuel Ferreira-Magalhães27Manuel Ferreira-Magalhães28Paula Leiria Pinto29Nicole Pinto30Ana Castro Neves31Ana Morête32Filipa Todo Bom33Alberto Costa34Diana Silva35Maria João Vasconcelos36Helena Falcão37Maria Luís Marques38Ana Mendes39João Cardoso40José Carlos Cidrais Rodrigues41Georgeta Oliveira42Joana Carvalho43Carlos Lozoya44Natacha Santos45Fernando Menezes46Ricardo Gomes47Rita Câmara48Rodrigo Rodrigues Alves49Ana Sofia Moreira50Carmo Abreu51Rui Silva52Diana Bordalo53Diana Bordalo54Carlos Alves55Cristina Lopes56Cristina Lopes57Luís Taborda-Barata58Luís Taborda-Barata59Ricardo M. Fernandes60Rosário Ferreira61Carla Chaves-Loureiro62Maria José Cálix63Adelaide Alves64João Almeida Fonseca65João Almeida Fonseca66João Almeida Fonseca67João Almeida Fonseca68Center for Health Technology and Services Research (CINTESIS), Faculty of Medicine, University of Porto, Porto, PortugalDepartment of Community Medicine, Information and Health Decision Sciences (MEDCIDS), Faculty of Medicine, University of Porto, Porto, PortugalCenter for Health Technology and Services Research (CINTESIS), Faculty of Medicine, University of Porto, Porto, PortugalDepartment of Community Medicine, Information and Health Decision Sciences (MEDCIDS), Faculty of Medicine, University of Porto, Porto, PortugalCenter for Health Technology and Services Research (CINTESIS), Faculty of Medicine, University of Porto, Porto, PortugalDepartment of Community Medicine, Information and Health Decision Sciences (MEDCIDS), Faculty of Medicine, University of Porto, Porto, PortugalAllergy Unit, Instituto and Hospital CUF, Porto, PortugalCenter for Health Technology and Services Research (CINTESIS), Faculty of Medicine, University of Porto, Porto, PortugalDepartment of Community Medicine, Information and Health Decision Sciences (MEDCIDS), Faculty of Medicine, University of Porto, Porto, PortugalDepartment of Cardiovascular and Respiratory Sciences, Porto Health School, Polytechnic Institute of Porto, Porto, PortugalDepartment of Women's and Children's Health, Pediatric Research, Uppsala University, Uppsala, SwedenCenter 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, PortugalAllergy Unit, Instituto and Hospital CUF, Porto, PortugalServiço de Imunoalergologia, Unidade I, Centro Hospitalar Vila Nova de Gaia/Espinho, Vila Nova de Gaia, PortugalServiço de Imunoalergologia, Unidade I, Centro Hospitalar Vila Nova de Gaia/Espinho, Vila Nova de Gaia, PortugalServiço de Imunoalergologia, Unidade I, Centro Hospitalar Vila Nova de Gaia/Espinho, Vila Nova de Gaia, PortugalAllergy Unit, Instituto and Hospital CUF, Porto, PortugalAllergy Unit, Instituto and Hospital CUF, Porto, PortugalServiço Pneumologia, Hospitais da Universidade de Coimbra, Coimbra, PortugalServiço de Pneumologia, Hospital Distrital da Figueira da Foz, Figueira da Foz, PortugalServiço Pneumologia, Hospitais da Universidade de Coimbra, Coimbra, PortugalServiço Pneumologia, Hospitais da Universidade de Coimbra, Coimbra, PortugalServiço de Imunoalergologia, Centro Hospitalar e Universitário de Coimbra, Coimbra, Portugal0Imunoalergologia, Centro Hospitalar de Leiria, Leiria, Portugal1Serviço de Pediatria, Centro Materno Infantil do Norte, Centro Hospitalar Universitário do Porto, Porto, PortugalCenter for Health Technology and Services Research (CINTESIS), Faculty of Medicine, University of Porto, Porto, PortugalDepartment of Community Medicine, Information and Health Decision Sciences (MEDCIDS), Faculty of Medicine, University of Porto, Porto, Portugal1Serviço de Pediatria, Centro Materno Infantil do Norte, Centro Hospitalar Universitário do Porto, Porto, Portugal2Serviço de Imunoalergologia, Hospital de Dona Estefânia, Centro Hospitalar Universitário de Lisboa Central, Lisboa, Portugal2Serviço de Imunoalergologia, Hospital de Dona Estefânia, Centro Hospitalar Universitário de Lisboa Central, Lisboa, Portugal2Serviço de Imunoalergologia, Hospital de Dona Estefânia, Centro Hospitalar Universitário de Lisboa Central, Lisboa, Portugal3Serviço de Imunoalergologia, Hospital Infante D. Pedro, Centro Hospitalar Baixo Vouga, Aveiro, Portugal4Serviço de Pneumologia, Hospital Beatriz Ângelo, Loures, Portugal5Serviço de Pediatria, Hospital da Senhora da Oliveira, Guimarães, Portugal6Serviço de Imunoalergologia, Centro Hospitalar Universitário de São João, Porto, Portugal6Serviço de Imunoalergologia, Centro Hospitalar Universitário de São João, Porto, Portugal7Serviço de Imunoalergologia, Centro Hospitalar Universitário do Porto, Porto, Portugal7Serviço de Imunoalergologia, Centro Hospitalar Universitário do Porto, Porto, Portugal8Serviço de Imunoalergologia, Hospital de Santa Maria, Centro Hospitalar Universitário Lisboa Norte, Lisboa, Portugal9Serviço de Pneumologia, Hospital Santa Marta, Centro Hospitalar Universitário de Lisboa Central, Lisboa, Portugal0Serviço de Pediatria, Hospital Pedro Hispano, Unidade Local de Saúde de Matosinhos, Matosinhos, Portugal0Serviço de Pediatria, Hospital Pedro Hispano, Unidade Local de Saúde de Matosinhos, Matosinhos, Portugal0Serviço de Pediatria, Hospital Pedro Hispano, Unidade Local de Saúde de Matosinhos, Matosinhos, Portugal1Serviço de Imunoalergologia, Hospital Amato Lusitano, Unidade Local de Saúde de Castelo Branco, Castelo Branco, Portugal2Serviço de Imunoalergologia, Centro Hospitalar Universitário do Algarve, Portimão, Portugal3Serviço de Pneumologia, Hospital Garcia de Orta, Almada, Portugal3Serviço de Pneumologia, Hospital Garcia de Orta, Almada, Portugal4Serviço de Imunoalergologia, Serviço de Saúde da Região Autónoma da Madeira, Funchal, Portugal5Serviço de Imunoalergologia, Hospital do Divino Espírito Santo, Ponta Delgada, Portugal5Serviço de Imunoalergologia, Hospital do Divino Espírito Santo, Ponta Delgada, Portugal6Serviço de Imunoalergologia, Hospital São Pedro de Vila Real, Centro Hospitalar De Trás-Os-Montes E Alto Douro, Vila Real, Portugal6Serviço de Imunoalergologia, Hospital São Pedro de Vila Real, Centro Hospitalar De Trás-Os-Montes E Alto Douro, Vila Real, PortugalCenter for Health Technology and Services Research (CINTESIS), Faculty of Medicine, University of Porto, Porto, Portugal7Serviço de Pediatria, Unidade Hospitalar de Famalicão, Centro Hospitalar do Médio Ave, Vila Nova de Famalicão, Portugal8Serviço de Pneumologia, Hospital Nossa Senhora do Rosário, Centro Hospitalar Barreiro Montijo, Barreiro, Portugal9Unidade de Imunoalergologia, Hospital Pedro Hispano, Unidade Local de Saúde de Matosinhos, Matosinhos, Portugal0Imunologia Básica e Clínica, Faculdade de Medicina, Universidade do Porto, Porto, Portugal1Department of Allergy and Clinical Immunology, Cova da Beira University Hospital Center, Covilhã, Portugal2CICS - Health Sciences Research Center, University of Beira Interior; NuESA –Environment and Health Study Group, Faculty of Health Sciences, Covilhã, Portugal3Departamento de Pediatria, Hospital de Santa Maria, Centro Hospitalar de Lisboa Norte, Lisboa, Portugal3Departamento de Pediatria, Hospital de Santa Maria, Centro Hospitalar de Lisboa Norte, Lisboa, Portugal4Serviço Pediatria Ambulatória, Centro Hospitalar e Universitário de Coimbra, Coimbra, Portugal5Serviço de Pediatria, Hospital de São Teotónio, Centro Hospitalar Tondela–Viseu, Viseu, Portugal6Serviço de Pneumologia, Unidade I, Centro Hospitalar Vila Nova de Gaia/Espinho, Vila Nova de Gaia, PortugalCenter for Health Technology and Services Research (CINTESIS), Faculty of Medicine, University of Porto, Porto, PortugalDepartment of Community Medicine, Information and Health Decision Sciences (MEDCIDS), Faculty of Medicine, University of Porto, Porto, PortugalAllergy Unit, Instituto and Hospital CUF, Porto, Portugal7MEDIDA – Medicina, Educação, Investigação, Desenvolvimento e Avaliação, Porto, PortugalBackground: Poor medication adherence is a major challenge in asthma and objective assessment of inhaler adherence is needed. InspirerMundi app aims to monitor inhaler adherence while turning it into a positive experience through gamification and social support.Objective: We assessed the medium-term feasibility of the InspirerMundi app to monitor inhaler adherence in real-world patients with persistent asthma (treated with daily inhaled medication). In addition, we attempted to identify the characteristics of the patients related to higher app use.Methods: Two real-world multicenter observational studies, with one initial face-to-face visit and a 4-month telephone interview, were conducted in 29 secondary care centers from Portugal. During an initial face-to-face visit, patients were invited to use the app daily to register their asthma medication intakes. A scheduled intake was considered taken when patients took a photo of the medication (inhaler, blister, or others) using the image-based medication detection tool. Medication adherence was calculated as the number of doses taken as a percentage of the number scheduled. Interacting with the app ≥30 days was used as the cut-off for higher app use.Results: A total of 114 patients {median 20 [percentile 25 to percentile 75 (P25–P75) 16–36] years, 62% adults} were invited, 107 (94%) installed the app and 83 (73%) completed the 4-month interview. Patients interacted with the app for a median of 18 [3–45] days, translated on a median use rate of 15 [3–38]%. Median inhaler adherence assessed through the app was 34 [4–73]% when considering all scheduled inhalations for the study period. Inhaler adherence assessed was not significantly correlated with self-reported estimates. Median adherence for oral and other medication was 41 [6–83]% and 43 [3–73]%, respectively. Patients with higher app use were slightly older (p = 0.012), more frequently taking medication for other health conditions (p = 0.040), and more frequently prescribed long-acting muscarinic antagonists (LAMA, p = 0.024). After 4 months, Control of Allergic Rhinitis and Asthma Test (CARAT) scores improved (p < 0.001), but no differences between patients interacting with the app for 30 days or less were seen.Conclusions: The InspirerMundi app was feasible to monitor inhaler adherence in patients with persistent asthma. The persistent use of this mHealth technology varies widely. A better understanding of characteristics related to higher app use is still needed before effectiveness studies are undertaken.https://www.frontiersin.org/articles/10.3389/fmedt.2021.649506/fullmHealthsmartphonetechnology assessmentmedication adherenceself-managementpatient participation |
| spellingShingle | Cristina Jácome Cristina Jácome Rute Almeida Rute Almeida Ana Margarida Pereira Ana Margarida Pereira Ana Margarida Pereira Rita Amaral Rita Amaral Rita Amaral Rita Amaral Pedro Vieira-Marques Sandra Mendes Magna Alves-Correia José Alberto Ferreira Inês Lopes Joana Gomes Luís Araújo Mariana Couto Cláudia Chaves Loureiro Lilia Maia Santos Ana Arrobas Margarida Valério Ana Todo Bom João Azevedo Maria Fernanda Teixeira Manuel Ferreira-Magalhães Manuel Ferreira-Magalhães Manuel Ferreira-Magalhães Paula Leiria Pinto Nicole Pinto Ana Castro Neves Ana Morête Filipa Todo Bom Alberto Costa Diana Silva Maria João Vasconcelos Helena Falcão Maria Luís Marques Ana Mendes João Cardoso José Carlos Cidrais Rodrigues Georgeta Oliveira Joana Carvalho Carlos Lozoya Natacha Santos Fernando Menezes Ricardo Gomes Rita Câmara Rodrigo Rodrigues Alves Ana Sofia Moreira Carmo Abreu Rui Silva Diana Bordalo Diana Bordalo Carlos Alves Cristina Lopes Cristina Lopes Luís Taborda-Barata Luís Taborda-Barata Ricardo M. Fernandes Rosário Ferreira Carla Chaves-Loureiro Maria José Cálix Adelaide Alves João Almeida Fonseca João Almeida Fonseca João Almeida Fonseca João Almeida Fonseca Monitoring Adherence to Asthma Inhalers Using the InspirerMundi App: Analysis of Real-World, Medium-Term Feasibility Studies Frontiers in Medical Technology mHealth smartphone technology assessment medication adherence self-management patient participation |
| title | Monitoring Adherence to Asthma Inhalers Using the InspirerMundi App: Analysis of Real-World, Medium-Term Feasibility Studies |
| title_full | Monitoring Adherence to Asthma Inhalers Using the InspirerMundi App: Analysis of Real-World, Medium-Term Feasibility Studies |
| title_fullStr | Monitoring Adherence to Asthma Inhalers Using the InspirerMundi App: Analysis of Real-World, Medium-Term Feasibility Studies |
| title_full_unstemmed | Monitoring Adherence to Asthma Inhalers Using the InspirerMundi App: Analysis of Real-World, Medium-Term Feasibility Studies |
| title_short | Monitoring Adherence to Asthma Inhalers Using the InspirerMundi App: Analysis of Real-World, Medium-Term Feasibility Studies |
| title_sort | monitoring adherence to asthma inhalers using the inspirermundi app analysis of real world medium term feasibility studies |
| topic | mHealth smartphone technology assessment medication adherence self-management patient participation |
| url | https://www.frontiersin.org/articles/10.3389/fmedt.2021.649506/full |
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