Back to Search Start Over

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

Authors :
Cristina Jácome
Rute Almeida
Ana Margarida Pereira
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
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
Carlos Alves
Cristina Lopes
Luís Taborda-Barata
Ricardo M. Fernandes
Rosário Ferreira
Carla Chaves-Loureiro
Maria José Cálix
Adelaide Alves
João Almeida Fonseca
Source :
Frontiers in Medical Technology, Vol 3 (2021)
Publication Year :
2021
Publisher :
Frontiers Media S.A., 2021.

Abstract

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.

Details

Language :
English
ISSN :
26733129
Volume :
3
Database :
Directory of Open Access Journals
Journal :
Frontiers in Medical Technology
Publication Type :
Academic Journal
Accession number :
edsdoj.f6efa89149994c92b313a51e6e434762
Document Type :
article
Full Text :
https://doi.org/10.3389/fmedt.2021.649506