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

Author

Jácome, Cristina, Almeida, Rute, Pereira, Ana Margarida, Amaral, Rita, Mendes, Sandra, Alves-Correia, Magna, Vidal, Carmen, López Freire, Sara, Méndez Brea, Paula, Araújo, Luís, Couto, Mariana, Antolín-Amérigo, Darío, de la Hoz Caballer, Belén, Barra Castro, Alicia, Gonzalez-De-Olano, David, Todo Bom, Ana, Azevedo, João, Leiria Pinto, Paula, Pinto, Nicole, Castro Neves, Ana, Palhinha, Ana, Todo Bom, Filipa, Costa, Alberto, Chaves Loureiro, Cláudia, Maia Santos, Lilia, Arrobas, Ana, Valério, Margarida, Cardoso, João, Emiliano, Madalena, Gerardo, Rita, Cidrais Rodrigues, José Carlos, Oliveira, Georgeta, Carvalho, Joana, Mendes, Ana, Lozoya, Carlos, Santos, Natacha, Menezes, Fernando, Gomes, Ricardo, Câmara, Rita, Rodrigues Alves, Rodrigo, Moreira, Ana Sofia, Bordalo, Diana, Alves, Carlos, Ferreira, José Alberto, Lopes, Cristina, Silva, Diana, Vasconcelos, Maria João, Teixeira, Maria Fernanda, Ferreira-Magalhães, Manuel, Taborda-Barata, Luís, Cálix, Maria José, Alves, Adelaide, and Almeida Fonseca, João

Subjects
Information technology, T58.5-58.64, Public aspects of medicine, RA1-1270
Abstract

BackgroundPoor 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. ObjectiveThis 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). MethodsA 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. ResultsA 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%). ConclusionsThe 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.

Published
2021
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2. Type 2 inflammation: a Portuguese consensus using Web-Delphi and decision conferencing (INFLAT2-PT).

Author

Costa, Suzete, Aguiar, João Pedro, Oliveira, Mónica D., Gonçalves, João, Ribeiro, João Carlos, Taborda-Barata, Luís, Farinha, Helena, Escada, Pedro, Fernandes, Samuel, Soares-de-Almeida, Luís, Paiva-Lopes, Maria João, Chaves Loureiro, Cláudia, Lourinho, Isabel, Fonseca, João A., Drummond, Marta, Marinho, Rui Tato, Bana e Costa, João, Vaz Carneiro, António, and Bana e Costa, Carlos A.

Abstract

Objectives: Atopic/allergic diseases impose a growing burden on public health, affecting millions of patients worldwide. The main objective of this study was to develop a national expert consensus on relevant clinical questions related to type 2 inflammation. Methods: We conducted: a comprehensive literature review with a qualitative analysis to identify the most repeated themes on the overlap of conditions; a modified 3-round Web-Delphi (or e-Delphi); and a final online decision conference. Results: We included 51 studies. Following three Web-Delphi rounds, we ended up with 30 statements with a 76% overall full agreement rate, 16% agreement, 2% disagreement, and 0% full disagreement. The decision conference enabled adjustments, and the expert panel agreed unanimously on the final set of statements. The consensus used evidence synthesis, Web-Delphi, and decision conference to produce 30 statements on type 2 inflammation as a driver for multimorbidity in asthma, certain rhinitis phenotypes, atopic dermatitis, chronic rhinosinusitis with nasal polyps, and eosinophilic esophagitis grouped under five domains in underlying pathophysiology, multimorbidity, diagnosis and management, multidisciplinary management, and impact on mental health. Conclusion: We expect the first Portuguese expert consensus INFLAT2-PT to promote understanding of type 2 inflammation diseases, multidisciplinary care, integrated care pathways, future research, and inform health authorities. [ABSTRACT FROM AUTHOR]

Published
2025
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5. Comparative effectiveness of anti-IL5 and anti-IgE biologic classes in patients with severe asthma eligible for both

Author

Pfeffer, Paul E., Ali, Nasloon, Murray, Ruth, Ulrik, Charlotte, Tran, Trung N., Maspero, Jorge, Peters, Matthew, Christoff, George C., Sadatsafavi, Mohsen, Torres-Duque, Carlos A., Altraja, Alan, Lehtimäki, Lauri, Papadopoulos, Nikolaos G, Salvi, Sundeep, Costello, Richard W., Cushen, Breda, Heffler, Enrico, Iwanaga, Takashi, Al-Ahmad, Mona, Larenas-Linnemann, Désirée, Kuna, Piotr, Fonseca, João A., Al-Lehebi, Riyad, Rhee, Chin Kook, Perez-de-Llano, Luis, Perng Steve, Diahn Warng, Mahboub, Bassam, Wang, Eileen, Goh, Celine, Lyu, Juntao, Newell, Anthony, Alacqua, Marianna, Belevskiy, Andrey S., Bhutani, Mohit, Bjermer, Leif, Bjornsdottir, Unnur, Bourdin, Arnaud, Bulow, Anna von, Busby, John, Canonica, Giorgio Walter, Cosio, Borja G., Dorscheid, Delbert R., Muñoz-Esquerre, Mariana, FitzGerald, J. Mark, Gil, Esther Garcia, Gibson, Peter G., Heaney, Liam G., Hew, Mark, Hilberg, Ole, Hoyte, Flavia, Jackson, David J., Koh, Mariko Siyue, Ko, Hsin Kuo Bruce, Lee, Jae Ha, Lehmann, Sverre, Chaves Loureiro, Cláudia, Lúðvíksdóttir, Dóra, Menzies-Gow, Andrew N., Mitchell, Patrick, Papaioannou, Andriana I., Popov, Todor A., Porsbjerg, Celeste M., Salameh, Laila, Sirena, Concetta, Taillé, Camille, Taube, Christian, Tohda, Yuji, Wechsler, Michael E., Price, David B., Pfeffer, Paul E., Ali, Nasloon, Murray, Ruth, Ulrik, Charlotte, Tran, Trung N., Maspero, Jorge, Peters, Matthew, Christoff, George C., Sadatsafavi, Mohsen, Torres-Duque, Carlos A., Altraja, Alan, Lehtimäki, Lauri, Papadopoulos, Nikolaos G, Salvi, Sundeep, Costello, Richard W., Cushen, Breda, Heffler, Enrico, Iwanaga, Takashi, Al-Ahmad, Mona, Larenas-Linnemann, Désirée, Kuna, Piotr, Fonseca, João A., Al-Lehebi, Riyad, Rhee, Chin Kook, Perez-de-Llano, Luis, Perng Steve, Diahn Warng, Mahboub, Bassam, Wang, Eileen, Goh, Celine, Lyu, Juntao, Newell, Anthony, Alacqua, Marianna, Belevskiy, Andrey S., Bhutani, Mohit, Bjermer, Leif, Bjornsdottir, Unnur, Bourdin, Arnaud, Bulow, Anna von, Busby, John, Canonica, Giorgio Walter, Cosio, Borja G., Dorscheid, Delbert R., Muñoz-Esquerre, Mariana, FitzGerald, J. Mark, Gil, Esther Garcia, Gibson, Peter G., Heaney, Liam G., Hew, Mark, Hilberg, Ole, Hoyte, Flavia, Jackson, David J., Koh, Mariko Siyue, Ko, Hsin Kuo Bruce, Lee, Jae Ha, Lehmann, Sverre, Chaves Loureiro, Cláudia, Lúðvíksdóttir, Dóra, Menzies-Gow, Andrew N., Mitchell, Patrick, Papaioannou, Andriana I., Popov, Todor A., Porsbjerg, Celeste M., Salameh, Laila, Sirena, Concetta, Taillé, Camille, Taube, Christian, Tohda, Yuji, Wechsler, Michael E., and Price, David B.

Abstract

Background Patients with severe asthma may present with characteristics representing overlapping phenotypes, making them eligible for more than one class of biologic. Our aim was to describe the profile of adult patients with severe asthma eligible for both anti-IgE and anti-IL5/5R and to compare the effectiveness of both classes of treatment in real life. Methods This was a prospective cohort study that included adult patients with severe asthma from 22 countries enrolled into the International Severe Asthma registry (ISAR) who were eligible for both anti-IgE and anti-IL5/5R. The effectiveness of anti-IgE and anti-IL5/5R was compared in a 1:1 matched cohort. Exacerbation rate was the primary effectiveness endpoint. Secondary endpoints included long-term-oral corticosteroid (LTOCS) use, asthma-related emergency room (ER) attendance, and hospital admissions. Results In the matched analysis (n = 350/group), the mean annualized exacerbation rate decreased by 47.1% in the anti-IL5/5R group and 38.7% in the anti-IgE group. Patients treated with anti-IL5/5R were less likely to experience a future exacerbation (adjusted IRR 0.76; 95% CI 0.64, 0.89; p < 0.001) and experienced a greater reduction in mean LTOCS dose than those treated with anti-IgE (37.44% vs. 20.55% reduction; p = 0.023). There was some evidence to suggest that patients treated with anti-IL5/5R experienced fewer asthma-related hospitalizations (IRR 0.64; 95% CI 0.38, 1.08), but not ER visits (IRR 0.94, 95% CI 0.61, 1.43). Conclusions In real life, both anti-IgE and anti-IL5/5R improve asthma outcomes in patients eligible for both biologic classes; however, anti-IL5/5R was superior in terms of reducing asthma exacerbations and LTOCS use., Background: Patients with severe asthma may present with characteristics representing overlapping phenotypes, making them eligible for more than one class of biologic. Our aim was to describe the profile of adult patients with severe asthma eligible for both anti-IgE and anti-IL5/5R and to compare the effectiveness of both classes of treatment in real life. Methods: This was a prospective cohort study that included adult patients with severe asthma from 22 countries enrolled into the International Severe Asthma registry (ISAR) who were eligible for both anti-IgE and anti-IL5/5R. The effectiveness of anti-IgE and anti-IL5/5R was compared in a 1:1 matched cohort. Exacerbation rate was the primary effectiveness endpoint. Secondary endpoints included long-term-oral corticosteroid (LTOCS) use, asthma-related emergency room (ER) attendance, and hospital admissions. Results: In the matched analysis (n = 350/group), the mean annualized exacerbation rate decreased by 47.1% in the anti-IL5/5R group and 38.7% in the anti-IgE group. Patients treated with anti-IL5/5R were less likely to experience a future exacerbation (adjusted IRR 0.76; 95% CI 0.64, 0.89; p < 0.001) and experienced a greater reduction in mean LTOCS dose than those treated with anti-IgE (37.44% vs. 20.55% reduction; p = 0.023). There was some evidence to suggest that patients treated with anti-IL5/5R experienced fewer asthma-related hospitalizations (IRR 0.64; 95% CI 0.38, 1.08), but not ER visits (IRR 0.94, 95% CI 0.61, 1.43). Conclusions: In real life, both anti-IgE and anti-IL5/5R improve asthma outcomes in patients eligible for both biologic classes; however, anti-IL5/5R was superior in terms of reducing asthma exacerbations and LTOCS use.

Published
2023

6. Comparative effectiveness of anti‐IL5 and anti‐IgE biologic classes in patients with severe asthma eligible for both

Author

Pfeffer, Paul E., primary, Ali, Nasloon, additional, Murray, Ruth, additional, Ulrik, Charlotte, additional, Tran, Trung N., additional, Maspero, Jorge, additional, Peters, Matthew, additional, Christoff, George C., additional, Sadatsafavi, Mohsen, additional, Torres‐Duque, Carlos A., additional, Altraja, Alan, additional, Lehtimäki, Lauri, additional, Papadopoulos, Nikolaos G., additional, Salvi, Sundeep, additional, Costello, Richard W., additional, Cushen, Breda, additional, Heffler, Enrico, additional, Iwanaga, Takashi, additional, Al‐Ahmad, Mona, additional, Larenas‐Linnemann, Désirée, additional, Kuna, Piotr, additional, Fonseca, João A., additional, Al‐Lehebi, Riyad, additional, Rhee, Chin Kook, additional, Perez‐de‐Llano, Luis, additional, Perng Steve, Diahn‐Warng, additional, Mahboub, Bassam, additional, Wang, Eileen, additional, Goh, Celine, additional, Lyu, Juntao, additional, Newell, Anthony, additional, Alacqua, Marianna, additional, Belevskiy, Andrey S., additional, Bhutani, Mohit, additional, Bjermer, Leif, additional, Bjornsdottir, Unnur, additional, Bourdin, Arnaud, additional, Bulow, Anna von, additional, Busby, John, additional, Canonica, Giorgio Walter, additional, Cosio, Borja G., additional, Dorscheid, Delbert R., additional, Muñoz‐Esquerre, Mariana, additional, FitzGerald, J. Mark, additional, Gil, Esther Garcia, additional, Gibson, Peter G., additional, Heaney, Liam G., additional, Hew, Mark, additional, Hilberg, Ole, additional, Hoyte, Flavia, additional, Jackson, David J., additional, Koh, Mariko Siyue, additional, Ko, Hsin‐Kuo Bruce, additional, Lee, Jae Ha, additional, Lehmann, Sverre, additional, Chaves Loureiro, Cláudia, additional, Lúðvíksdóttir, Dóra, additional, Menzies‐Gow, Andrew N., additional, Mitchell, Patrick, additional, Papaioannou, Andriana I., additional, Popov, Todor A., additional, Porsbjerg, Celeste M., additional, Salameh, Laila, additional, Sirena, Concetta, additional, Taillé, Camille, additional, Taube, Christian, additional, Tohda, Yuji, additional, Wechsler, Michael E., additional, and Price, David B., additional

Published
2023
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7. Severe asthma in the era of COVID-19

Author

Gaspar-Marques, João, van Zeller, Mafalda, Carreiro-Martins, Pedro, Chaves Loureiro, Cláudia, NOVA Medical School|Faculdade de Ciências Médicas (NMS|FCM), and Comprehensive Health Research Centre (CHRC) - pólo NMS

Subjects
Pulmonary and Respiratory Medicine, SARS-CoV-2, Monoclonal, Covid-19, Antibodies, Asthma
Abstract

Funding Information: João Gaspar Marques has received research grants from AstraZeneca and honorarium as speaker/consultant from AstraZeneca, Novartis, Sanofi and TEVA. Mafalda van Zeller has received honorarium as speaker/consultant from AstraZeneca, GlaxoSmithKline, Novartis and TEVA. Pedro Carreiro Martins has received research grants from AstraZeneca and honorarium as speaker/consultant from AstraZeneca, GlaxoSmithKline, Novartis and Sanofi. Cláudia Chaves Loureiro has received honorarium as speaker/consultant from AstraZeneca, GlaxoSmithKline, Novartis, Sanofi and TEVA. Publisher Copyright: © 2021 Sociedade Portuguesa de Pneumologia Copyright: Copyright 2021 Elsevier B.V., All rights reserved. Introduction and objectives: Severe asthma management during the coronavirus disease 2019 (COVID-19) pandemic is a challenge and will continue to be, at least in the next few months, as herd immunity is still a mirage. A lot has to be learned about how COVID-19 affects underlying diseases, and severe asthma is no exception. Methods: Narrative review of papers available until February 2021 in PubMed and Google Scholar, relating severe asthma and COVID-19. Four main research topics were reviewed: SARS-CoV-2 infection: immunology and respiratory pathology; interrelationship of severe asthma endotypes and COVID-19 disease mechanisms; severe asthma epidemiology and COVID-19; and biologics for severe asthma in the context of COVID-19. Results: COVID-19 disease mechanisms start with upper respiratory cell infection, and afterwards several immunological facets are activated, contributing to disease severity, namely cell-mediated immunity and antibody production. Although infrequent in the COVID-19 course some patients develop a cytokine storm that causes organ damage and may lead to acute respiratory distress syndrome or multiorgan failure. Regarding severe asthma endotypes, type2-high might have a protective role both in infection risk and disease course. There is conflicting data regarding the epidemiological relationship between COVID-19 among severe asthma patients, with some studies reporting increased risk of infection and disease course, whereas others the other way round. Biologics for severe asthma do not seem to increase the risk of infection and severe COVID-19, although further evidence is needed. Conclusions: Globally, in the era of COVID-19, major respiratory societies recommend continuing the biologic treatment, preferably in a self-home administration program. publishersversion published

Published
2022

8. Metabolic phenotypes in asthmatic adults

Author

Santos, Adalberto, Pité, Helena, Chaves-Loureiro, Cláudia, Rocha, Sílvia M., Taborda-Barata, Luís, NOVA Medical School|Faculdade de Ciências Médicas (NMS|FCM), and Centro de Estudos de Doenças Crónicas (CEDOC)

Subjects
Phenotypes, SDG 3 - Good Health and Well-being, Endocrinology, Diabetes and Metabolism, Endotypes, Metabolomics, Biochemistry, Molecular Biology, Asthma, respiratory tract diseases
Abstract

Bronchial asthma is a chronic disease that affects individuals of all ages. It has a high prevalence and is associated with high morbidity and considerable levels of mortality. However, asthma is not a single disease, and multiple subtypes or phenotypes (clinical, inflammatory or combinations thereof) can be detected, namely in aggregated clusters. Most studies have characterised asthma phenotypes and clusters of phenotypes using mainly clinical and inflammatory parameters. These studies are important because they may have clinical and prognostic implications and may also help to tailor personalised treatment approaches. In addition, various metabolomics studies have helped to further define the metabolic features of asthma, using electronic noses or targeted and untargeted approaches. Besides discriminating between asthma and a healthy state, metabolomics can detect the metabolic signatures associated with some asthma subtypes, namely eosinophilic and non-eosinophilic phenotypes or the obese asthma phenotype, and this may prove very useful in point-of-care application. Furthermore, metabolomics also discriminates between asthma and other “phenotypes” of chronic obstructive airway diseases, such as chronic obstructive pulmonary disease (COPD) or Asthma–COPD Overlap (ACO). However, there are still various aspects that need to be more thoroughly investigated in the context of asthma phenotypes in adequately designed, homogeneous, multicentre studies, using adequate tools and integrating metabolomics into a multiple-level approach. publishersversion published

Published
2021

9. Determinants of the Use of Health and Fitness Mobile Apps by Patients With Asthma: Secondary Analysis of Observational Studies

Author

Neves, Ana Luísa, primary, Jácome, Cristina, additional, Taveira-Gomes, Tiago, additional, Pereira, Ana Margarida, additional, Almeida, Rute, additional, Amaral, Rita, additional, Alves-Correia, Magna, additional, Mendes, Sandra, additional, Chaves-Loureiro, Cláudia, additional, Valério, Margarida, additional, Lopes, Cristina, additional, Carvalho, Joana, additional, Mendes, Ana, additional, Ribeiro, Carmelita, additional, Prates, Sara, additional, Ferreira, José Alberto, additional, Teixeira, Maria Fernanda, additional, Branco, Joana, additional, Santalha, Marta, additional, Vasconcelos, Maria João, additional, Lozoya, Carlos, additional, Santos, Natacha, additional, Cardia, Francisca, additional, Moreira, Ana Sofia, additional, Taborda-Barata, Luís, additional, Pinto, Cláudia Sofia, additional, Ferreira, Rosário, additional, Morais Silva, Pedro, additional, Monteiro Ferreira, Tania, additional, Câmara, Raquel, additional, Lobo, Rui, additional, Bordalo, Diana, additional, Guimarães, Cristina, additional, Espírito Santo, Maria, additional, Ferraz de Oliveira, José, additional, Cálix Augusto, Maria José, additional, Gomes, Ricardo, additional, Vieira, Inês, additional, da Silva, Sofia, additional, Marques, Maria, additional, Cardoso, João, additional, Morete, Ana, additional, Aroso, Margarida, additional, Cruz, Ana Margarida, additional, Nunes, Carlos, additional, Câmara, Rita, additional, Rodrigues, Natalina, additional, Abreu, Carmo, additional, Albuquerque, Ana Luísa, additional, Vieira, Claúdia, additional, Santos, Carlos, additional, Páscoa, Rosália, additional, Chaves-Loureiro, Carla, additional, Alves, Adelaide, additional, Neves, Ângela, additional, Varanda Marques, José, additional, Reis, Bruno, additional, Ferreira-Magalhães, Manuel, additional, and Almeida Fonseca, João, additional

Published
2021
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10. Engagement with an asthma app to monitor medication adherence and its association with patients’ characteristics

Author

Oliveira Jácome, Cristina Isabel, primary, Almeida, Rute, additional, Pereira, Ana Margarida, additional, Amaral, Rita, additional, Mendes, Sandra, additional, Alves-Correia, Magna, additional, Vidal, Carmen, additional, López Freire, Sara, additional, Méndez Brea, Paula, additional, Araujo, Luis, additional, Couto, Mariana, additional, Antolín-Amérigo, Darío, additional, De La Hoz Caballer, Belén, additional, Barra Castro, Alicia, additional, Gonzalez-De-Olano, David, additional, Todo Bom, Ana, additional, Azevedo, João, additional, Leiria Pinto, Paula, additional, Pinto, Nicole, additional, Castro Neves, Ana, additional, Palhinha, Ana, additional, Todo Bom, Filipa, additional, Costa, Alberto, additional, Chaves Loureiro, Cláudia, additional, Maia Santos, Lilia, additional, Arrobas, Ana, additional, Valério, Margarida, additional, Cardoso, João, additional, Emiliano, Madalena, additional, Gerardo, Rita, additional, Cidrais Rodrigues, José Carlos, additional, Oliveira, Georgeta, additional, Carvalho, Joana, additional, Mendes, Ana, additional, Lozoya, Carlos, additional, Santos, Natacha, additional, Menezes, Fernando, additional, Gomes, Ricardo, additional, Câmara, Rita, additional, Rodrigues Alves, Rodrigo, additional, Moreira, Ana Sofia, additional, Bordalo, Diana, additional, Alves, Carlos, additional, Coelho-Barreiro, Didina, additional, Ferreira, José Alberto, additional, Lopes, Cristina, additional, Silva, Diana, additional, Vasconcelos, Maria João, additional, Teixeira, Maria Fernanda, additional, Ferreira-Magalhães, Manuel, additional, Taborda-Barata, Luís, additional, Cálix, Maria José, additional, Alves, Adelaide, additional, and Almeida Fonseca, João, additional

Published
2021
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12. Monitoring Adherence to Asthma Inhalers Using the InspirerMundi App: Analysis of Real-World, Medium-Term Feasibility Studies

Author

Jácome, Cristina, primary, Almeida, Rute, additional, Pereira, Ana Margarida, additional, Amaral, Rita, additional, Vieira-Marques, Pedro, additional, Mendes, Sandra, additional, Alves-Correia, Magna, additional, Ferreira, José Alberto, additional, Lopes, Inês, additional, Gomes, Joana, additional, Araújo, Luís, additional, Couto, Mariana, additional, Chaves Loureiro, Cláudia, additional, Santos, Lilia Maia, additional, Arrobas, Ana, additional, Valério, Margarida, additional, Todo Bom, Ana, additional, Azevedo, João, additional, Teixeira, Maria Fernanda, additional, Ferreira-Magalhães, Manuel, additional, Pinto, Paula Leiria, additional, Pinto, Nicole, additional, Neves, Ana Castro, additional, Morête, Ana, additional, Bom, Filipa Todo, additional, Costa, Alberto, additional, Silva, Diana, additional, Vasconcelos, Maria João, additional, Falcão, Helena, additional, Marques, Maria Luís, additional, Mendes, Ana, additional, Cardoso, João, additional, Cidrais Rodrigues, José Carlos, additional, Oliveira, Georgeta, additional, Carvalho, Joana, additional, Lozoya, Carlos, additional, Santos, Natacha, additional, Menezes, Fernando, additional, Gomes, Ricardo, additional, Câmara, Rita, additional, Alves, Rodrigo Rodrigues, additional, Moreira, Ana Sofia, additional, Abreu, Carmo, additional, Silva, Rui, additional, Bordalo, Diana, additional, Alves, Carlos, additional, Lopes, Cristina, additional, Taborda-Barata, Luís, additional, Fernandes, Ricardo M., additional, Ferreira, Rosário, additional, Chaves-Loureiro, Carla, additional, Cálix, Maria José, additional, Alves, Adelaide, additional, and Fonseca, João Almeida, additional

Published
2021
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13. Feasibility and Acceptability of an Asthma App to Monitor Medication Adherence: Mixed Methods Study (Preprint)

Author

Jácome, Cristina, primary, Almeida, Rute, additional, Pereira, Ana Margarida, additional, Amaral, Rita, additional, Mendes, Sandra, additional, Alves-Correia, Magna, additional, Vidal, Carmen, additional, López Freire, Sara, additional, Méndez Brea, Paula, additional, Araújo, Luís, additional, Couto, Mariana, additional, Antolín-Amérigo, Darío, additional, de la Hoz Caballer, Belén, additional, Barra Castro, Alicia, additional, Gonzalez-De-Olano, David, additional, Todo Bom, Ana, additional, Azevedo, João, additional, Leiria Pinto, Paula, additional, Pinto, Nicole, additional, Castro Neves, Ana, additional, Palhinha, Ana, additional, Todo Bom, Filipa, additional, Costa, Alberto, additional, Chaves Loureiro, Cláudia, additional, Maia Santos, Lilia, additional, Arrobas, Ana, additional, Valério, Margarida, additional, Cardoso, João, additional, Emiliano, Madalena, additional, Gerardo, Rita, additional, Cidrais Rodrigues, José Carlos, additional, Oliveira, Georgeta, additional, Carvalho, Joana, additional, Mendes, Ana, additional, Lozoya, Carlos, additional, Santos, Natacha, additional, Menezes, Fernando, additional, Gomes, Ricardo, additional, Câmara, Rita, additional, Rodrigues Alves, Rodrigo, additional, Moreira, Ana Sofia, additional, Bordalo, Diana, additional, Alves, Carlos, additional, Ferreira, José Alberto, additional, Lopes, Cristina, additional, Silva, Diana, additional, Vasconcelos, Maria João, additional, Teixeira, Maria Fernanda, additional, Ferreira-Magalhães, Manuel, additional, Taborda-Barata, Luís, additional, Cálix, Maria José, additional, Alves, Adelaide, additional, and Almeida Fonseca, João, additional

Published
2020
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14. Determinants of use of health and fitness mobile apps by patients with asthma: secondary analysis of observational studies (Preprint)

Author

Neves, Ana Luísa, primary, Jácome, Cristina, additional, Taveira-Gomes, Tiago, additional, Pereira, Ana Margarida, additional, Almeida, Rute, additional, Amaral, Rita, additional, Alves-Correia, Magna, additional, Mendes, Sandra, additional, Chaves-Loureiro, Cláudia, additional, Valério, Margarida, additional, Lopes, Cristina, additional, Carvalho, Joana, additional, Mendes, Ana, additional, Ribeiro, Carmelita, additional, Prates, Sara, additional, Ferreira, José Alberto, additional, Teixeira, Maria Fernanda, additional, Branco, Joana, additional, Santalha, Marta, additional, Vasconcelos, Maria João, additional, Lozoya, Carlos, additional, Santos, Natacha, additional, Cardia, Francisca, additional, Moreira, Ana Sofia, additional, Taborda-Barata, Luís, additional, Pinto, Cláudia Sofia, additional, Ferreira, Rosário, additional, Morais Silva, Pedro, additional, Monteiro Ferreira, Tania, additional, Câmara, Raquel, additional, Lobo, Rui, additional, Bordalo, Diana, additional, Guimarães, Cristina, additional, Espírito Santo, Maria, additional, Ferraz de Oliveira, José, additional, Cálix Augusto, Maria José, additional, Gomes, Ricardo, additional, Vieira, Inês, additional, da Silva, Sofia, additional, Marques, Maria, additional, Cardoso, João, additional, Morete, Ana, additional, Aroso, Margarida, additional, Cruz, Ana Margarida, additional, Nunes, Carlos, additional, Câmara, Rita, additional, Rodrigues, Natalina, additional, Abreu, Carmo, additional, Albuquerque, Ana Luísa, additional, Vieira, Claúdia, additional, Santos, Carlos, additional, Páscoa, Rosália, additional, Chaves-Loureiro, Carla, additional, Alves, Adelaide, additional, Neves, Ângela, additional, Varanda Marques, José, additional, Reis, Bruno, additional, Ferreira-Magalhães, Manuel, additional, and Almeida Fonseca, João, additional

Published
2020
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15. Latent classes of adults with persistent asthma: data from the multicentre INSPIRERS studies

Author

Amaral, Rita, primary, Jácome, Cristina, additional, Almeida, Rute, additional, Pereira, Ana, additional, Chaves Loureiro, Cláudia, additional, Lopes, Cristina, additional, Mendes, Ana, additional, Cidrais-Rodrigues, José Carlos, additional, Carvalho, Joana, additional, Arrobas, Ana, additional, Todo Bom, Ana, additional, Ribeiro, Carmelita, additional, Azevedo, João, additional, Leiria Pinto, Paula, additional, Neuparth, Nuno, additional, Todo-Bom, Filipa, additional, Costa, Alberto, additional, Lozoya, Carlos, additional, Santos, Natacha, additional, Silva, Diana, additional, Taborda-Barata, Luís, additional, Rodrigues-Alves, Rodrigo, additional, Moreira, Ana Sofia, additional, Pinto, Cláudia Sofia, additional, Morais Silva, Pedro, additional, Alves, Carlos, additional, Câmara, Raquel, additional, Bordalo, Diana, additional, Fernandes, Ricardo, additional, Ferreira, Rosário, additional, Ferraz De Oliveira, José, additional, Menezes, Fernando, additional, Gomes, Ricardo, additional, Cálix, Maria José, additional, Cardoso, João, additional, Nunes, Carlos, additional, Câmara, Rita, additional, Ferreira, José Alberto, additional, Ferreira-Magalhães, Manuel, additional, Vidal, Carmen, additional, López Freire, Sara, additional, Méndez Brea, Paula, additional, Antolín-Amérigo, Darío, additional, De La Hoz Caballer, Belén, additional, Barra Castro, Alicia, additional, Gonzalez-De-Olano, David, additional, and Fonseca, João A., additional

Published
2020
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16. Feasibility of an asthma app to monitor medication adherence

Author

Oliveira Jácome, Cristina Isabel, primary, Almeida, Rute, additional, Amaral, Rita, additional, Pereira, Ana Margarida, additional, Vidal, Carmen, additional, López Freire, Sara, additional, Méndez Brea, Paula, additional, Antolín-Amérigo, Darío, additional, De La Hoz Caballer, Belén, additional, Barra Castro, Alicia, additional, Gonzalez-De-Olano, David, additional, Todo Bom, Ana, additional, Azevedo, João, additional, Leiria Pinto, Paula, additional, Neuparth, Nuno, additional, Todo Bom, Filipa, additional, Costa, Alberto, additional, Chaves Loureiro, Cláudia, additional, Arrobas, Ana, additional, Valério, Margarida, additional, Cardoso, João, additional, Cidrais Rodrigues, José Carlos, additional, Oliveira, Georgeta, additional, Carvalho, Joana, additional, Mendes, Ana, additional, Lozoya, Carlos, additional, Santos, Natacha, additional, Menezes, Fernando, additional, Gomes, Ricardo, additional, Câmara, Rita, additional, Rodrigues Alves, Rodrigo, additional, Moreira, Ana Sofia, additional, Bordalo, Diana, additional, Alves, Carlos, additional, Coelho, Didina, additional, Ferreira, José Alberto, additional, Lopes, Cristina, additional, Silva, Diana, additional, Vasconcelos, Maria João, additional, Teixeira, Maria Fernanda, additional, Taborda-Barata, Luís, additional, Cálix, Maria José, additional, Alves, Adelaide, additional, and Almeida Fonseca, João, additional

Published
2020
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17. The first 30 months of the Portuguese Severe Asthma Registry

Author

Sá-Sousa, Ana, primary, Brás, Rita, additional, Amaral, Luís, additional, Mendes, Ana, additional, Videira, Wanda, additional, Pardal, Cecília, additional, Alberto Ferreira, José, additional, Sokolova, Anna, additional, Chaves Loureiro, Cláudia, additional, Faria, Emília, additional, Arrobas, Ana, additional, Lopes, Cristina, additional, Ribeiro, Liliana, additional, Mesquita, Márcio, additional, Silva, Inês, additional, Drummond, Marta, additional, Santos, Natacha, additional, Alendouro, Paula, additional, Carreiro-Martins, Pedro, additional, Lima, Ricardo, additional, Caldeira, Vânia, additional, and Fonseca, João A, additional

Published
2020
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18. Patient engagement with an asthma app to improve inhaler adherence

Author

Oliveira Jácome, Cristina Isabel, primary, Almeida, Rute, additional, Amaral, Rita, additional, Pereira, Ana Margarida, additional, Todo Bom, Ana, additional, Azevedo, João, additional, Leiria Pinto, Paula, additional, Neuparth, Nuno, additional, Todo Bom, Filipa, additional, Costa, Alberto, additional, Chaves Loureiro, Cláudia, additional, Arrobas, Ana, additional, Valério, Margarida, additional, Cardoso, João, additional, Cidrais Rodrigues, José Carlos, additional, Oliveira, Georgeta, additional, Carvalho, Joana, additional, Mendes, Ana, additional, Lozoya, Carlos, additional, Santos, Natacha, additional, Menezes, Fernando, additional, Gomes, Ricardo, additional, Câmara, Rita, additional, Rodrigues Alves, Rodrigo, additional, Moreira, Ana Sofia, additional, Bordalo, Diana, additional, Alves, Carlos, additional, Coelho, Didina, additional, Ferreira, José Alberto, additional, Lopes, Cristina, additional, Silva, Diana, additional, Vasconcelos, Maria João, additional, Teixeira, Maria Fernanda, additional, Taborda-Barata, Luís, additional, Cálix, Maria José, additional, Alves, Adelaide, additional, and Almeida Fonseca, João, additional

Published
2020
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21. Patient-physician discordance in assessment of adherence to inhaled controller medication: a cross-sectional analysis of two cohorts.

Author

Jácome, Cristina, Margarida Pereira, Ana, Almeida, Rute, Ferreira-Magalhaes, Manuel, Couto, Mariana, Araujo, Luís, Pereira, Mariana, Alves Correia, Magna, Chaves Loureiro, Cláudia, Joana Catarata, Maria, Maia Santos, Lília, Pereira, João, Ramos, Bárbara, Lopes, Cristina, Mendes, Ana, Cidrais Rodrigues, José Carlos, Oliveira, Georgeta, Paula Aguiar, Ana, Afonso, Ivete, and Carvalho, Joana

Abstract

Objective We aimed to compare patient’s and physician’s ratings of inhaled medication adherence and to identify predictors of patient-physician discordance. Design Baseline data from two prospective multicentre observational studies. Setting 29 allergy, pulmonology and paediatric secondary care outpatient clinics in Portugal. Participants 395 patients (≥13 years old) with persistent asthma. Measures Data on demographics, patient-physician relationship, upper airway control, asthma control, asthma treatment, forced expiratory volume in one second (FEV1) and healthcare use were collected. Patients and physicians independently assessed adherence to inhaled controller medication during the previous week using a 100 mm Visual Analogue Scale (VAS). Discordance was defined as classification in distinct VAS categories (low 0–50; medium 51–80; high 81–100) or as an absolute difference in VAS scores ≥10 mm. Correlation between patients’ and physicians’ VAS scores/categories was explored. A multinomial logistic regression identified the predictors of physician overestimation and underestimation. Results High inhaler adherence was reported both by patients (median (percentile 25 to percentile 75) 85 (65–95) mm; 53% VAS>80) and by physicians (84 (68–95) mm; 53% VAS>80). Correlation between patient and physician VAS scores was moderate (rs=0.580; p<0.001). Discordance occurred in 56% of cases: in 28% physicians overestimated adherence and in 27% underestimated. Low adherence as assessed by the physician (OR=27.35 (9.85 to 75.95)), FEV1 ≥80% (OR=2.59 (1.08 to 6.20)) and a first appointment (OR=5.63 (1.24 to 25.56)) were predictors of underestimation. An uncontrolled asthma (OR=2.33 (1.25 to 4.34)), uncontrolled upper airway disease (OR=2.86 (1.35 to 6.04)) and prescription of short-acting beta-agonists alone (OR=3.05 (1.15 to 8.08)) were associated with overestimation. Medium adherence as assessed by the physician was significantly associated with higher risk of discordance, both for overestimation and underestimation of adherence (OR=14.50 (6.04 to 34.81); OR=2.21 (1.07 to 4.58)), while having a written action plan decreased the likelihood of discordance (OR=0.25 (0.12 to 0.52); OR=0.41 (0.22 to 0.78)) (R2=44%). Conclusion Although both patients and physicians report high inhaler adherence, discordance occurred in half of cases. Implementation of objective adherence measures and effective communication are needed to improve patient-physician agreement. [ABSTRACT FROM AUTHOR]

Published
2019
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24. Benralizumab in severe eosinophilic asthma by previous biologic use and key clinical subgroups: real-world XALOC-1 programme.

Author

Jackson DJ, Pelaia G, Emmanuel B, Tran TN, Cohen D, Shih VH, Shavit A, Arbetter D, Katial R, Rabe APJ, Garcia Gil E, Pardal M, Nuevo J, Watt M, Boarino S, Kayaniyil S, Chaves Loureiro C, Padilla-Galo A, and Nair P

Subjects
Humans, Male, Female, Middle Aged, Retrospective Studies, Adult, Treatment Outcome, Aged, Eosinophils, Adrenal Cortex Hormones therapeutic use, Adrenal Cortex Hormones administration & dosage, Eosinophilia drug therapy, Asthma drug therapy, Antibodies, Monoclonal, Humanized therapeutic use, Anti-Asthmatic Agents therapeutic use
Abstract

Background: Pivotal phase 3 trials and real-world studies have demonstrated benralizumab's overall efficacy and safety in severe eosinophilic asthma (SEA). Additional large-cohort data are needed to confirm its real-world effectiveness in SEA according to previous biologic use and key baseline characteristics important for treatment selection., Methods: XALOC-1 is a large, multinational, retrospective, observational, real-world study programme of benralizumab in adults with SEA. This 48-week integrated analysis assessed annualised exacerbation rate (AER), maintenance oral corticosteroid (mOCS) use, asthma symptom control and lung function during a 12-month baseline period and up to 48 weeks after benralizumab initiation. Subgroup analyses were based on previous biologic use and key baseline clinical characteristics (mOCS use, blood eosinophil count, exacerbation history, age at asthma diagnosis, fractional exhaled nitric oxide level and presence of atopy and chronic rhinosinusitis with nasal polyps)., Results: Out of 1002 patients analysed, 380 were biologic-experienced. At week 48, 71.3% were exacerbation-free ( versus 17.2% at baseline); relative reduction in AER was 82.7% overall and 72.9% in biologic-experienced patients; rates were maintained across all key clinical characteristic subgroups. Of patients using mOCS at baseline (n=274), 47.4% (130 out of 274) eliminated their use by week 48; the mean reduction from baseline in daily dose was 51.2% and, notably, 34.9% in biologic-experienced patients (n=115). Clinically significant improvements in asthma symptom control and lung function were observed., Conclusion: In this large, real-world programme, SEA patients treated with benralizumab had substantial improvements in clinical outcomes irrespective of previous biologic use and key clinical characteristics important to therapeutic decision-making in clinical practice., Competing Interests: Conflict of interest: D.J. Jackson has received consultancy fees and speakers’ fees from AstraZeneca, Boehringer Ingelheim, Chiesi, GlaxoSmithKline and Sanofi Regeneron, and research grants from AstraZeneca. G. Pelaia has received lecture fees and advisory board fees from AstraZeneca, Boehringer Ingelheim, Chiesi, GlaxoSmithKline, Guidotti, Insmed, Lusofarmaco, Menarini, Neopharmed Gentili, Novartis, Sanofi and Zambon. B. Emmanuel, T.N. Tran, D. Cohen, V.H. Shih, A. Shavit, M. Watt, S. Kayaniyil, M. Pardal, D. Arbetter and A.P.J. Rabe are employees of, and own stock in, AstraZeneca. S. Boarino and J. Nuevo are employees of AstraZeneca. R. Katial (currently of National Jewish Health and University of Colorado Denver, Denver, CO, USA) and E. Garcia-Gil (currently of Almirall, Barcelona, Spain) were employees of AstraZeneca at the time the study was conducted. C. Chaves Loureiro has received consultancy fees and speakers’ fees from AstraZeneca, Chiesi, GlaxoSmithKline, Sanofi Regeneron and Teva, and research grants from GlaxoSmithKline. A. Padilla-Galo reports grants, personal fees and non-financial support from AstraZeneca and Sanofi, personal fees, and non-financial support from Chiesi, GlaxoSmithKline, Novartis and Teva, and personal fees from ALK, Bial and FAES, outside the submitted work. P. Nair reports that in the past two years, his institution received grant support from AstraZeneca, Cyclomedica, Equillium, Foresee, Genentech, Sanofi and Teva; he has also received honoraria from Arrowhead, AstraZeneca, CSL Behring, GlaxoSmithKline and Sanofi., (Copyright ©The authors 2024.)

Published
2024
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