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

Medientyp: E-Artikel
Titel: Monitoring Adherence to Asthma Inhalers Using the InspirerMundi App: Analysis of Real-World, Medium-Term Feasibility Studies
Beteiligte: Jácome, Cristina; Almeida, Rute; Pereira, Ana Margarida; Amaral, Rita; Vieira-Marques, Pedro; Mendes, Sandra; Alves-Correia, Magna; Ferreira, José Alberto; Lopes, Inês; Gomes, Joana; Araújo, Luís; Couto, Mariana; Chaves Loureiro, Cláudia; Santos, Lilia Maia; Arrobas, Ana; Valério, Margarida; Todo Bom, Ana; Azevedo, João; Teixeira, Maria Fernanda; Ferreira-Magalhães, Manuel; Pinto, Paula Leiria; Pinto, Nicole; Neves, Ana Castro; Morête, Ana; [...]
Erschienen: Frontiers Media SA, 2021
Erschienen in: Frontiers in Medical Technology
Sprache: Nicht zu entscheiden
DOI: 10.3389/fmedt.2021.649506
ISSN: 2673-3129
Schlagwörter: General Earth and Planetary Sciences ; General Environmental Science
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Beschreibung: <jats:p><jats:bold>Background:</jats:bold> 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.</jats:p><jats:p><jats:bold>Objective:</jats:bold> 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.</jats:p><jats:p><jats:bold>Methods:</jats:bold> 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.</jats:p><jats:p><jats:bold>Results:</jats:bold> 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 (<jats:italic>p</jats:italic> = 0.012), more frequently taking medication for other health conditions (<jats:italic>p</jats:italic> = 0.040), and more frequently prescribed long-acting muscarinic antagonists (LAMA, <jats:italic>p</jats:italic> = 0.024). After 4 months, Control of Allergic Rhinitis and Asthma Test (CARAT) scores improved (<jats:italic>p</jats:italic> &lt; 0.001), but no differences between patients interacting with the app for 30 days or less were seen.</jats:p><jats:p><jats:bold>Conclusions:</jats:bold> 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.</jats:p>
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