Monitoring Adherence to Asthma Inhalers Using the InspirerMundi App: Analysis of Real-World, Medium-Term Feasibility Studies

被引：6

作者：

Jacome, Cristina ^{[1
,2
]}

Almeida, Rute ^{[1
,2
]}

Pereira, Ana Margarida ^{[1
,2
,3
]}

Amaral, Rita ^{[1
,2
,4
,5
]}

Vieira-Marques, Pedro ^{[1
]}

Mendes, Sandra ^{[1
]}

Alves-Correia, Magna ^{[3
]}

Ferreira, Jose Alberto ^{[6
]}

Lopes, Ines ^{[6
]}

Gomes, Joana ^{[6
]}

Araujo, Luis ^{[3
]}

Couto, Mariana ^{[3
]}

Chaves Loureiro, Claudia ^{[7
]}

Santos, Lilia Maia ^{[8
]}

Arrobas, Ana ^{[7
]}

Valerio, Margarida ^{[7
]}

Todo Bom, Ana ^{[9
]}

Azevedo, Joao ^{[10
]}

Teixeira, Maria Fernanda ^{[11
]}

Ferreira-Magalhaes, Manuel ^{[1
,2
,11
]}

Pinto, Paula Leiria ^{[12
]}

Pinto, Nicole ^{[12
]}

Neves, Ana Castro ^{[12
]}

Morete, Ana ^{[13
]}

Bom, Filipa Todo ^{[14
]}

Costa, Alberto ^{[15
]}

Silva, Diana ^{[16
]}

Vasconcelos, Maria Joao ^{[16
]}

Falcao, Helena ^{[17
]}

Marques, Maria Luis ^{[17
]}

Mendes, Ana ^{[18
]}

Cardoso, Joao ^{[19
]}

Cidrais Rodrigues, Jose Carlos ^{[20
]}

Oliveira, Georgeta ^{[20
]}

Carvalho, Joana ^{[20
]}

Lozoya, Carlos ^{[21
]}

Santos, Natacha ^{[22
]}

Menezes, Fernando ^{[23
]}

Gomes, Ricardo ^{[23
]}

Camara, Rita ^{[24
]}

Alves, Rodrigo Rodrigues ^{[25
]}

Moreira, Ana Sofia ^{[25
]}

Abreu, Carmo ^{[26
]}

Silva, Rui ^{[26
]}

Bordalo, Diana ^{[1
,27
,28
]}

Alves, Carlos

Lopes, Cristina ^{[29
,30
]}

Taborda-Barata, Luis ^{[31
,32
,33
]}

Fernandes, Ricardo M. M. ^{[34
]}

Ferreira, Rosario ^{[34
]}

机构：

[1] Univ Porto, Fac Med, Ctr Hlth Technol & Serv Res CINTESIS, Porto, Portugal

[2] Univ Porto, Fac Med, Dept Community Med Informat & Hlth Decis Sci MEDC, Porto, Portugal

[3] Inst & Hosp CUF, Allergy Unit, Porto, Portugal

[4] Polytech Inst Porto, Porto Hlth Sch, Dept Cardiovasc & Resp Sci, Porto, Portugal

[5] Uppsala Univ, Dept Womens & Childrens Hlth, Pediat Res, Uppsala, Sweden

[6] Ctr Hosp Vila Nova De Gaia Espinho, Serv Imunoalergol, Unidade 1, Vila Nova De Gaia, Portugal

[7] Hosp Univ Coimbra, Serv Pneumol, Coimbra, Portugal

[8] Hosp Dist Figueira Da Foz, Serv Pneumol, Figueira Da Foz, Portugal

[9] Ctr Hosp & Univ Coimbra, Serv Imunoalergol, Coimbra, Portugal

[10] Ctr Hosp Leiria, Imunoalergol, Leiria, Portugal

[11] Ctr Hosp Univ Porto, Ctr Materno Infantil Norte, Serv Pediat, Porto, Portugal

[12] Ctr Hosp Univ Lisboa Cent, Hosp Dona Estefania, Serv Imunoalergol, Lisbon, Portugal

[13] Ctr Hosp Baixo Vouga, Hosp Infante D Pedro, Serv Imunoalergol, Aveiro, Portugal

[14] Hosp Beatriz Angelo, Serv Pneumol, Loures, Portugal

[15] Hosp Senhora Oliveira, Serv Pediat, Guimaraes, Portugal

[16] Ctr Hosp Univ Sao Joao, Serv Imunoalergol, Porto, Portugal

[17] Ctr Hosp Univ Porto, Serv Imunoalergol, Porto, Portugal

[18] Ctr Hosp Univ Lisboa Norte, Hosp Santa Maria, Serv Imunoalergol, Lisbon, Portugal

[19] Ctr Hosp Univ Lisboa Cent, Hosp Santa Marta, Serv Pneumol, Lisbon, Portugal

[20] Hosp Pedro Hispano, Serv Pediat, Unidade Local Saude Matosinhos, Matosinhos, Portugal

[21] Hosp Amato Lusitano, Serv Imunoalergol, Unidade Local Saude Castelo Branco, Castelo Branco, Portugal

[22] Ctr Hosp Univ Algarve, Serv Imunoalergol, Portimao, Portugal

[23] Hosp Garcia Orta, Serv Pneumol, Almada, Portugal

[24] Serv Saude Reg Autonoma Madeira, Serv Imunoalergol, Funchal, Portugal

[25] Hosp Divino Espirito Santo, Serv Imunoalergol, Ponta Delgada, Portugal

[26] Hosp Sao Pedro Vila Real, Ctr Hosp Tras Os Montes & Alto Douro, Serv Imunoalergol, Vila Real, Portugal

[27] Unidade Hosp Famalicao, Serv Pediat, Ctr Hosp Medio Ave, Vila Nova De Famalicao, Portugal

[28] Hosp Nossa Senhora Rosario, Ctr Hosp Barreiro Montijo, Serv Pneumol, Barreiro, Portugal

[29] Hosp Pedro Hispano, Unidade Imunoalergol, Unidade Local Saude Matosinhos, Matosinhos, Portugal

[30] Univ Porto, Fac Med, Imunol Bas & Clin, Porto, Portugal

[31] Cova Beira Univ Hosp Ctr, Dept Allergy & Clin Immunol, Covilha, Portugal

[32] Univ Beira Interior, CICS Hlth Sci Res Ctr, Covilha, Portugal

[33] NuESA Environm & Hlth Study Grp, Fac Hlth Sci, Covilha, Portugal

[34] Ctr Hosp Lisboa Norte, Hosp Santa Maria, Dept Pediat, Lisbon, Portugal

[35] Ctr Hosp & Univ Coimbra, Serv Pediat Ambulatoria, Coimbra, Portugal

[36] Hosp Sao Teotonio, Ctr Hosp Tondela Viseu, Serv Pediat, Viseu, Portugal

[37] Ctr Hosp Vila Nova De Gaia Espinho, Serv Pneumol, Unidade 1, Vila Nova De Gaia, Portugal

[38] MEDIDA Med Educ Invest Desenvolvimento & Avaliaca, Porto, Portugal

来源：

FRONTIERS IN MEDICAL TECHNOLOGY | 2021年 / 3卷

关键词：

mHealth; smartphone; technology assessment; medication adherence; self-management; patient participation; MEDICATION ADHERENCE; HEALTH;

D O I：

10.3389/fmedt.2021.649506

中图分类号：

R318 [生物医学工程];

学科分类号：

0831 ;

摘要：

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.

引用

页数：11

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