scholarly journals Feasibility and acceptability of an asthma app to monitor medication adherence: a mixed methods study (Preprint)

2020 ◽  
Author(s):  
Cristina Jácome ◽  
Rute Almeida ◽  
Ana Margarida Pereira ◽  
Rita Amaral ◽  
Sandra Mendes ◽  
...  
Keyword(s):  
Medication Adherence ◽  
Objective Assessment ◽  
Persistent Asthma ◽  
Patient Centered ◽  
Symptom Monitoring ◽  
Multicenter Observational Study ◽  
Detection Tool ◽  
Adolescents And Adults ◽  
Adherence Monitoring ◽  
Inhaled Medication

BACKGROUND Poor medication adherence is a major challenge in asthma and objective assessment of inhaler adherence is needed. InspirerMundi app aims to monitor adherence while turning into 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 recipient) 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)-5(high) scale. Patients were also asked to point out the most and least preferred app features and to make suggestions for future app improvements. RESULTS A total of 107 patients (median 27[P25-P75 14-40] years) were invited, 99 (93%) installed the app and 79 (74%) completed the 1-month interview. Patients interacted with the app a median of 9[1-24] days. At least one medication was registered in the app by 77 patients (72%). Fifty-two (53%) participants registered all prescribed inhalers and 34 (34%) registered the complete asthma therapeutic plan. Median medication adherence was 75[25-90]% for inhalers and 82[50-94]% for other drug formulations. Patients were globally satisfied with the app, with 75% scoring ≥4, with the adherence monitoring, symptom monitoring and gamification features being the most highly scored components and the medication detection tool among the lowest scored (53% ≥4). 53% of the patients stated that the app had motivated them to improve adherence to inhaled medication and 77% would recommend the app to other patients. Patients’ feedback was reflected in four major themes: Medication-related features (n=67, 85%), Gamification and social network (n=33, 42%), Symptom monitoring and physician communication (n=21, 27, and Other aspects (n=16, 20%). CONCLUSIONS The InspirerMundi app was feasible and acceptable to monitor medication adherence in patients with asthma. Based on patients’ feedback and to increase the registering of medications, the therapeutic plan registration and the medication detection tool were redesigned. Our results highlight the importance of patient participation to produce a patient-centered and engaging mHealth asthma app.

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

2021 ◽  
Vol 3 ◽  
Author(s):  
Cristina Jácome ◽  
Rute Almeida ◽  
Ana Margarida Pereira ◽  
Rita Amaral ◽  
Pedro Vieira-Marques ◽  
...  
Keyword(s):  
Medication Adherence ◽  
Real World ◽  
Objective Assessment ◽  
Persistent Asthma ◽  
Feasibility Studies ◽  
Medium Term ◽  
Face To Face ◽  
Long Acting ◽  
Effectiveness Studies ◽  
Inhaled Medication

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.

scholarly journals Advancing Patient-Centered Care in Tuberculosis Management: A Mixed-Methods Appraisal of Video Directly Observed Therapy

2018 ◽  
Vol 5 (4) ◽  
Author(s):  
Samuel B Holzman ◽  
Avi Zenilman ◽  
Maunank Shah
Keyword(s):  
Mixed Methods ◽  
Medication Adherence ◽  
Cost Analysis ◽  
Patient Specific ◽  
Directly Observed Therapy ◽  
Patient Privacy ◽  
Framework Analysis ◽  
Self Administration ◽  
Patient Centered ◽  
Adherence Monitoring

Abstract Background Directly observed therapy (DOT) remains an integral component of treatment support and adherence monitoring in tuberculosis care. In-person DOT is resource intensive and often burdensome for patients. Video DOT (vDOT) has been proposed as an alternative to increase treatment flexibility and better meet patient-specific needs. Methods We conducted a pragmatic, prospective pilot implementation of vDOT at 3 TB clinics in Maryland. A mixed-methods approach was implemented to assess (1) effectiveness, (2) acceptability, and (3) cost. Medication adherence on vDOT was compared with that of in-person DOT. Interviews and surveys were conducted with patients and providers before and after implementation, with framework analysis utilized to extract salient themes. Last, a cost analysis assessed the economic impacts of vDOT implementation across heterogeneous clinic structures. Results Medication adherence on vDOT was comparable to that of in-person DOT (94% vs 98%, P = .17), with a higher percentage of total treatment doses (inclusive of weekend/holiday self-administration) ultimately observed during the vDOT period (72% vs 66%, P = .03). Video DOT was well received by staff and patients alike, who cited increased treatment flexibility, convenience, and patient privacy. Our cost analysis estimated a savings with vDOT of $1391 per patient for a standard 6-month treatment course. Conclusions Video DOT is an acceptable and important option for measurement of TB treatment adherence and may allow a higher proportion of prescribed treatment doses to be observed, compared with in-person DOT. Video DOT may be cost-saving and should be considered as a component of individualized, patient-centered case management plans.

scholarly journals Patient-Centered Care, Diabetes Empowerment, and Type 2 Diabetes Medication Adherence Among American Indian Patients

2017 ◽  
Vol 35 (5) ◽  
pp. 281-285 ◽  
Author(s):  
Nathan L. Ratner ◽  
Emily B. Davis ◽  
Laura L. Lhotka ◽  
Stephanie M. Wille ◽  
Melissa L. Walls
Keyword(s):  
Type 2 Diabetes ◽  
Medication Adherence ◽  
American Indian ◽  
Patient Centered Care ◽  
Patient Centered ◽  
Diabetes Medication ◽  
Indian Patients ◽  
Centered Care ◽  
Diabetes Empowerment

Biomarkers to Predict Response to ICS and LAMA in Adolescents and Adults with Mild Persistent Asthma

2021 ◽  
Author(s):  
Jerry A Krishnan ◽  
Stephen C. Lazarus ◽  
Kathryn V Blake ◽  
Christine A Sorkness ◽  
Ronina Covar ◽  
...  
Keyword(s):  
Persistent Asthma ◽  
Adolescents And Adults ◽  
Mild Persistent Asthma

scholarly journals Effects of nonlinear error correction of measurements obtained by peak flowmeter using the Wright scale to assess asthma attack severity in children

2007 ◽  
Vol 135 (5-6) ◽  
pp. 310-316
Author(s):  
Dragana Stamatovic ◽  
Nada Bokan-Erdeljan
Keyword(s):  
Objective Assessment ◽  
Airflow Obstruction ◽  
Persistent Asthma ◽  
Percentage Error ◽  
British Thoracic Society ◽  
Asthma Attack ◽  
Calibration Methods ◽  
Measurement Results ◽  
Before And After ◽  
Severe Degree

Introduction: Monitoring of peak expiratory flow (PEF) is recommended in numerous guidelines for management of asthma. Improvements in calibration methods have demonstrated the inaccuracy of original Wright scale of peak flowmeter. A new standard, EN 13826 that was applied to peak flowmeter was adopted on 1st September 2004 by some European countries. Correction of PEF readings obtained with old type devices for measurement is possible by Dr M. Miller?s original predictive equation. Objective. Assessment of PEF correction effect on the interpretation of measurement results and management decisions. Method. In children with intermittent (35) or stable persistent asthma (75) aged 6-16 years, there were performed 8393 measurements of PEF by Vitalograph normal-range peak flowmeter with traditional Wright scale. Readings were expressed as percentage of individual best values (PB) before and after correction. The effect of correction was analyzed based on The British Thoracic Society guidelines for asthma attack treatment. Results. In general, correction reduced the values of PEF (p<0.01). The highest mean percentage error (20.70%) in the measured values was found in the subgroup in which PB ranged between 250 and 350 l/min. Nevertheless, the interpretation of PEF after the correction in this subgroup changed in only 2.41% of measurements. The lowest mean percentage error (15.72%), and, at the same time, the highest effect of correction on measurement results interpretation (in 22.65% readings) were in children with PB above 450 l/min. In 73 (66.37%) subjects, the correction changed the clinical interpretation of some values of PEF after correction. In 13 (11.8%) patients, some corrected values indicated the absence or a milder degree of airflow obstruction. In 27 (24.54%) children, more than 10%, and in 12 (10.93%), more than 20% of the corrected readings indicated a severe degree of asthma exacerbation that needed more aggressive treatment. Conclusion. Correction of PEF values obtained by peak flowmeters with traditional Wright scale shows a possibility of overtreatment in younger or short stature children and undertreatment in older or taller ones if we use old type of metres. The correction of peak flowmeter for non-linear error is a prerequisite in the application of asthma guidelines in PEF measurements. .

The impact of technology on medication adherence

2013 ◽  
Vol 2 (8) ◽  
pp. 233-235
Author(s):  
Chelsie Heesch
Keyword(s):  
Mental Illness ◽  
Medication Adherence ◽  
Communication Systems ◽  
Intervention Strategies ◽  
Medication Nonadherence ◽  
Symptom Monitoring ◽  
Technological Advances ◽  
Therapeutic Outcomes ◽  
Impact Of Technology ◽  
The Impact

Medication nonadherence is a large contributor to inadequate therapeutic outcomes, especially among patients with mental illness and carries a high cost. Intervention strategies to increase adherence have incorporated technological advances, including electronic symptom monitoring and communication systems for patients and providers. This article presents a review of several studies demonstrating how technology may affect medication adherence.

Sign in / Sign up

Export Citation Format

Share Document