Browsing by Author "Alves, Carlos"
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- Bone decade actions: are practical results measurable yet?Publication . Alves, Sandra; Oliveira, Carla; Alves, Carlos; Ribeiro, Ana I.; Neves, Nuno; Pina, Maria F.Osteoarthritis (OA) has an extremely high disease and economic burden. Despite treatments for OA pain management, data are limited on the adequacy of pain relief in OA patients. SORT will determine the adequacy of pain relief in patients with knee OA and compare patterns of clinical care and outcomes.
- Exploring direct costs of primary hip and knee arthroplasties healthcare-associated infections: A retrospective studyPublication . Moura, João; Baylina, Pilar; Logarinho, João; Conceição, Filipe; São Simão, Ricardo; Alves, CarlosHip or knee arthroplasty healthcare-associated infections (HAI) are a public health problem that induces the increase of morbidity and mortality rates and poses an economic problem with significant impact on hospitals budget. The infection rate in primary hip and knee arthroplasties range between 1.5% and 2.5%, and is considered one of the main reasons for surgeries non-effectiveness. A retrospective study was carried out in S. João Hospital Center, EPE (CHSJ) to calculate HAI rate in primary hip and knee arthroplasties, and to analyse their direct costs, for a better understanding of their economic impact. Four hundred and eighty seven arthroplasties were studied and infection was noticed in 11 cases: 3 after hip and 8 after knee arthroplasties. Data collected from infected patients-related costs were compared with the average cost of non-infected patients (standard). An incidence rate of 2.17% for hip arthroplasties and 2.25% for knee arthroplasties was found. Results showed that patients with infection remained in hospital 7.45 times longer than uninfected patients and incurred hospital costs almost 3.8 times higher. This work shows how important is the quantification of additional HAI costs to allow hospital managers to weigh the cost/benefit ratio and better justify investments in HAI prevention and control programmes.
- Feasibility and acceptability of an asthma app to monitor medication adherence: mixed methods studyPublication . Jácome, Cristina; Almeida, Rute; Pereira, Ana Margarida; Amaral, Rita; Mendes, Sandra; Alves-Correia, Magna; Vidal, Carmen; Freire, Sara López; Brea, Paula Méndez; Araújo, Luís; Couto, Mariana; Antolín-Amérigo, Darío; Caballer, Belén de la Hoz; Castro, Alicia Barra; Gonzalez-De-Olano, David; Bom, Ana Todo; Azevedo, João; Pinto, Paula Leiria; Pinto, Nicole; Neves, Ana Castro; Palhinha, Ana; Bom, Filipa Todo; Costa, Alberto; Loureiro, Cláudia Chaves; Santos, Lilia Maia; Arrobas, Ana; Valério, Margarida; Cardoso, João; Emiliano, Madalena; Gerardo, Rita; Rodrigues, José Carlos Cidrais; Oliveira, Georgeta; Carvalho, Joana; Mendes, Ana; Lozoya, Carlos; Santos, Natacha; Menezes, Fernando; Gomes, Ricardo; Câmara, Rita; Alves, Rodrigo Rodrigues; 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; Fonseca, João AlmeidaPoor 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. 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). 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. 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%). 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.
- Validity and reliability of a new incremental step test for people with chronic obstructive pulmonary diseasePublication . Vilarinho, Rui; Serra, Lúcia; Águas, Ana; Alves, Carlos; Silva, Pedro Matos; Caneiras, Cátia; Mesquita Montes, AntónioIncremental step tests (IST) can be used to assess exercise capacity in people with chronic obstructive pulmonary disease (COPD). The development of a new step test based on the characteristics of the incremental shuttle walk test (ISWT) is an important study to explore. We aimed to develop a new IST based on the ISWT in people with COPD, and assess its validity (construct validity) and reliability, according to Consensus-based Standards for the selection of health status Measurement Instruments (COSMIN) recommendations. A cross-sectional study was conducted in participants recruited from hospitals/clinics. During the recruitment, the participants who presented a 6-minute walk test (6MWT) report in the previous month were also identified and the respective data was collected. Subsequently, participants attended two sessions at their homes. IST was conducted on the first visit, along with the 1 min sit-to-stand (1MSTS) test. IST was repeated on a second visit, performed 5–7 days after the first one. Spearman’s correlations were used for construct validity, by comparing the IST with the 6MWT and the 1MSTS. Intraclass correlation coefficient (ICC2,1), SE of measurement (SEM) and minimal detectable change at 95% CI (MDC95) were used for reliability. The learning effect was explored with the Wilcoxon signed-rank test. 50 participants (70.8±7.5 years) were enrolled. IST was significant and moderate correlated with the 6MWT (ρ=0.50, p=0.020), and with the 1MSTS (ρ=0.46, p=0.001). IST presented an ICC2,1=0.96, SEM=10.1 (16.6%) and MDC95=27.9 (45.8%) for the number of steps. There was a statistically significant difference between the two attempts of the IST (p=0.030). Despite the significant and moderate correlations with the 6MWT and 1MSTS, the inability to full compliance with the COSMIN recommendations does not yet allow the IST to be considered valid in people with COPD. On the other hand, the IST is a reliable test based on its high ICC, but a learning effect and an ‘indeterminate’ measurement error were shown.