Feasibility and Acceptability of an Asthma App to Monitor Medication Adherence: Mixed Methods Study.

Autor:	Jácome C; Center for Health Technology and Services Research, Faculty of Medicine, University of Porto, Porto, Portugal.; Department of Community Medicine, Faculty of Medicine, Information and Health Decision Sciences, University of Porto, Porto, Portugal., Almeida R; Center for Health Technology and Services Research, Faculty of Medicine, University of Porto, Porto, Portugal.; Department of Community Medicine, Faculty of Medicine, Information and Health Decision Sciences, University of Porto, Porto, Portugal., Pereira AM; Center for Health Technology and Services Research, Faculty of Medicine, University of Porto, Porto, Portugal.; Department of Community Medicine, Faculty of Medicine, Information and Health Decision Sciences, University of Porto, Porto, Portugal.; Allergy Unit, Instituto and Hospital CUF, Porto, Portugal., Amaral R; Center for Health Technology and Services Research, Faculty of Medicine, University of Porto, Porto, Portugal.; Department of Community Medicine, Faculty of Medicine, Information and Health Decision Sciences, University of Porto, Porto, Portugal.; Department of Cardiovascular and Respiratory Sciences, Porto Health School, Porto, Portugal.; Department of Women's and Children's Health, Paediatric Research, Uppsala University, Uppsala, Sweden., Mendes S; Center for Health Technology and Services Research, Faculty of Medicine, University of Porto, Porto, Portugal., Alves-Correia M; Allergy Unit, Instituto and Hospital CUF, Porto, Portugal., Vidal C; Servicio de Alergia, Complejo Hospitalario Universitario de Santiago, Santiago de Compostela, Spain., López Freire S; Servicio de Alergia, Complejo Hospitalario Universitario de Santiago, Santiago de Compostela, Spain., Méndez Brea P; Servicio de Alergia, Complejo Hospitalario Universitario de Santiago, Santiago de Compostela, Spain., Araújo L; Allergy Unit, Instituto and Hospital CUF, Porto, Portugal., Couto M; Allergy Unit, Instituto and Hospital CUF, Porto, Portugal., Antolín-Amérigo D; Servicio de Alergia, Hospital Universitario Ramón y Cajal, Instituto Ramón y Cajal de Investigación Sanitaria, Madrid, Spain., de la Hoz Caballer B; Servicio de Alergia, Hospital Universitario Ramón y Cajal, Instituto Ramón y Cajal de Investigación Sanitaria, Madrid, Spain., Barra Castro A; Servicio de Alergia, Hospital Universitario Ramón y Cajal, Instituto Ramón y Cajal de Investigación Sanitaria, Madrid, Spain., Gonzalez-De-Olano D; Servicio de Alergia, Hospital Universitario Ramón y Cajal, Instituto Ramón y Cajal de Investigación Sanitaria, Madrid, Spain., Todo Bom A; Serviço de Imunoalergologia, Centro Hospitalar e Universitário de Coimbra, Coimbra, Portugal., Azevedo J; Imunoalergologia, Centro Hospitalar de Leiria, Leiria, Portugal., Leiria Pinto P; Serviço de Imunoalergologia, Hospital de Dona Estefânia, Centro Hospitalar Universitário de Lisboa Central, Lisboa, Portugal., Pinto N; Serviço de Imunoalergologia, Hospital de Dona Estefânia, Centro Hospitalar Universitário de Lisboa Central, Lisboa, Portugal., Castro Neves A; Serviço de Imunoalergologia, Hospital de Dona Estefânia, Centro Hospitalar Universitário de Lisboa Central, Lisboa, Portugal., Palhinha A; Serviço de Imunoalergologia, Hospital de Dona Estefânia, Centro Hospitalar Universitário de Lisboa Central, Lisboa, Portugal., Todo Bom F; Serviço de Pneumologia, Hospital Beatriz Ângelo, Loures, Portugal., Costa A; Serviço de Pediatria, Hospital da Senhora da Oliveira, Guimarães, Portugal., Chaves Loureiro C; Serviço Pneumologia, Centro Hospitalar e Universitário de Coimbra, Coimbra, Portugal., Maia Santos L; Serviço de Pneumologia, Hospital Distrital da Figueira da Foz, Figueira da Foz, Portugal., Arrobas A; Serviço Pneumologia, Centro Hospitalar e Universitário de Coimbra, Coimbra, Portugal., Valério M; Serviço Pneumologia, Centro Hospitalar e Universitário de Coimbra, Coimbra, Portugal., Cardoso J; Serviço de Pneumologia, Hospital Santa Marta, Centro Hospitalar Universitário de Lisboa Central, Lisboa, Portugal., Emiliano M; Serviço de Pneumologia, Hospital Santa Marta, Centro Hospitalar Universitário de Lisboa Central, Lisboa, Portugal., Gerardo R; Serviço de Pneumologia, Hospital Santa Marta, Centro Hospitalar Universitário de Lisboa Central, Lisboa, Portugal., Cidrais Rodrigues JC; Serviço de Pediatria, Hospital Pedro Hispano, Unidade Local de Saúde de Matosinhos, Matosinhos, Portugal., Oliveira G; Serviço de Pediatria, Hospital Pedro Hispano, Unidade Local de Saúde de Matosinhos, Matosinhos, Portugal., Carvalho J; Serviço de Pediatria, Hospital Pedro Hispano, Unidade Local de Saúde de Matosinhos, Matosinhos, Portugal., Mendes A; Serviço de Imunoalergologia, Hospital de Santa Maria, Centro Hospitalar Universitário Lisboa Norte, Lisboa, Portugal., Lozoya C; Serviço de Imunoalergologia, Hospital Amato Lusitano, Unidade Local de Saúde de Castelo Branco, Castelo Branco, Portugal., Santos N; Serviço de Imunoalergologia, Centro Hospitalar Universitário do Algarve, Portimão, Portugal., Menezes F; Serviço de Pneumologia, Hospital Garcia de Orta, Almada, Portugal., Gomes R; Serviço de Pneumologia, Hospital Garcia de Orta, Almada, Portugal., Câmara R; Serviço de Imunoalergologia, Serviço de Saúde da Região Autónoma da Madeira, Funchal, Portugal., Rodrigues Alves R; Serviço de Imunoalergologia, Hospital do Divino Espírito Santo, Ponta Delgada, Portugal., Moreira AS; Serviço de Imunoalergologia, Hospital do Divino Espírito Santo, Ponta Delgada, Portugal., Bordalo D; Center for Health Technology and Services Research, Faculty of Medicine, University of Porto, Porto, Portugal.; Serviço de Pediatria, Unidade Hospitalar de Famalicão, Centro Hospitalar do Médio Ave, Vila Nova de Famalicão, Portugal., Alves C; Serviço de Pneumologia, Hospital Nossa Senhora do Rosário, Centro Hospitalar Barreiro Montijo, Barreiro, Portugal., Ferreira JA; Serviço de Imunoalergologia, Unidade I, Centro Hospitalar Vila Nova de Gaia/Espinho, Vila Nova de Gaia, Portugal., Lopes C; Unidade de Imunoalergologia, Hospital Pedro Hispano, Unidade Local de Saúde de Matosinhos, Matosinhos, Portugal.; Imunologia Básica e Clínica, Faculdade de Medicina, Universidade do Porto, Porto, Portugal., Silva D; Serviço de Imunoalergologia, Centro Hospitalar Universitário de São João, Porto, Portugal., Vasconcelos MJ; Serviço de Imunoalergologia, Centro Hospitalar Universitário de São João, Porto, Portugal., Teixeira MF; Serviço de Pediatria, Centro Materno Infantil do Norte, Centro Hospitalar Universitário do Porto, Porto, Portugal., Ferreira-Magalhães M; Center for Health Technology and Services Research, Faculty of Medicine, University of Porto, Porto, Portugal.; Department of Community Medicine, Faculty of Medicine, Information and Health Decision Sciences, University of Porto, Porto, Portugal.; Serviço de Pediatria, Centro Materno Infantil do Norte, Centro Hospitalar Universitário do Porto, Porto, Portugal., Taborda-Barata L; Department of Allergy & Clinical Immunology, Cova da Beira University Hospital Centre, Covilhã, Portugal.; Environment & Health Study Group, Faculty of Health Sciences, Health Sciences Research Centre, University of Beira Interior, Covilhã, Portugal., Cálix MJ; Serviço de Pediatria, Hospital de São Teotónio, Centro Hospitalar Tondela-Viseu, Viseu, Portugal., Alves A; Serviço de Pneumologia, Unidade I, Centro Hospitalar Vila Nova de Gaia/Espinho, Vila Nova de Gaia, Portugal., Almeida Fonseca J; Center for Health Technology and Services Research, Faculty of Medicine, University of Porto, Porto, Portugal.; Department of Community Medicine, Faculty of Medicine, Information and Health Decision Sciences, University of Porto, Porto, Portugal.; Allergy Unit, Instituto and Hospital CUF, Porto, Portugal.; Medicina, Educação, Investigação, Desenvolvimento e Avaliação, Porto, Portugal.
Jazyk:	angličtina
Zdroj:	JMIR mHealth and uHealth [JMIR Mhealth Uhealth] 2021 May 25; Vol. 9 (5), pp. e26442. Date of Electronic Publication: 2021 May 25.
DOI:	10.2196/26442
Abstrakt:	Background: Poor medication adherence is a major challenge in asthma, and objective assessment of inhaler adherence is needed. The InspirerMundi app aims to monitor adherence while providing a positive experience through gamification and social support. Objective: This study aimed to evaluate the feasibility and acceptability of the InspirerMundi app to monitor medication adherence in adolescents and adults with persistent asthma (treated with daily inhaled medication). Methods: A 1-month mixed method multicenter observational study was conducted in 26 secondary care centers from Portugal and Spain. During an initial face-to-face visit, physicians reported patients' asthma therapeutic plan in a structured questionnaire. During the visits, patients were invited to use the app daily to register their asthma medication intakes. A scheduled intake was considered taken when patients registered the intake (inhaler, blister, or other drug formulation) by using the image-based medication detection tool. At 1 month, patients were interviewed by phone, and app satisfaction was assessed on a 1 (low) to 5 (high) scale. Patients were also asked to point out the most and least preferred app features and make suggestions for future app improvements. Results: A total of 107 patients (median 27 [P25-P75 14-40] years) were invited, 92.5% (99/107) installed the app, and 73.8% (79/107) completed the 1-month interview. Patients interacted with the app a median of 9 (P25-P75 1-24) days. At least one medication was registered in the app by 78% (77/99) of patients. A total of 53% (52/99) of participants registered all prescribed inhalers, and 34% (34/99) registered the complete asthma therapeutic plan. Median medication adherence was 75% (P25-P75 25%-90%) for inhalers and 82% (P25-P75 50%-94%) for other drug formulations. Patients were globally satisfied with the app, with 75% (59/79) scoring ≥4,; adherence monitoring, symptom monitoring, and gamification features being the most highly scored components; and the medication detection tool among the lowest scored. A total of 53% (42/79) of the patients stated that the app had motivated them to improve adherence to inhaled medication and 77% (61/79) would recommend the app to other patients. Patient feedback was reflected in 4 major themes: medication-related features (67/79, 85%), gamification and social network (33/79, 42%), symptom monitoring and physician communication (21/79, 27%), and other aspects (16/79, 20%). Conclusions: The InspirerMundi app was feasible and acceptable to monitor medication adherence in patients with asthma. Based on patient feedback and to increase the registering of medications, the therapeutic plan registration and medication detection tool were redesigned. Our results highlight the importance of patient participation to produce a patient-centered and engaging mHealth asthma app. (©Cristina Jácome, Rute Almeida, Ana Margarida Pereira, Rita Amaral, Sandra Mendes, Magna Alves-Correia, Carmen Vidal, Sara López Freire, Paula Méndez Brea, Luís Araújo, Mariana Couto, Darío Antolín-Amérigo, Belén de la Hoz Caballer, Alicia Barra Castro, David Gonzalez-De-Olano, Ana Todo Bom, João Azevedo, Paula Leiria Pinto, Nicole Pinto, Ana Castro Neves, Ana Palhinha, Filipa Todo Bom, Alberto Costa, Cláudia Chaves Loureiro, Lilia Maia Santos, Ana Arrobas, Margarida Valério, João Cardoso, Madalena Emiliano, Rita Gerardo, José Carlos Cidrais Rodrigues, Georgeta Oliveira, Joana Carvalho, Ana Mendes, Carlos Lozoya, Natacha Santos, Fernando Menezes, Ricardo Gomes, Rita Câmara, Rodrigo Rodrigues Alves, Ana Sofia Moreira, Diana Bordalo, Carlos Alves, José Alberto Ferreira, Cristina Lopes, Diana Silva, Maria João Vasconcelos, Maria Fernanda Teixeira, Manuel Ferreira-Magalhães, Luís Taborda-Barata, Maria José Cálix, Adelaide Alves, João Almeida Fonseca. Originally published in JMIR mHealth and uHealth (https://mhealth.jmir.org), 25.05.2021.)
Databáze:	MEDLINE
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