Browsing by Author "Mendes, Sandra"
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- Determinants of the use of health and fitness mobile apps by patients with asthma: secondary analysis of observational studiesPublication . Neves, Ana Luísa; Jácome, Cristina; Taveira-Gomes, Tiago; Pereira, Ana Margarida; Almeida, Rute; Amaral, Rita; Alves-Correia, Magna; Mendes, Sandra; Chaves-Loureiro, Cláudia; Valério, Margarida; Lopes, Cristina; Carvalho, Joana; Mendes, Ana; Ribeiro, Carmelita; Prates, Sara; Ferreira, José Alberto; Teixeira, Maria Fernanda; Branco, Joana; Santalha, Marta; Vasconcelos, Maria João; Lozoya, Carlos; Santos, Natacha; Cardia, Francisca; Moreira, Ana Sofia; Taborda-Barata, Luís; Pinto, Cláudia Sofia; Ferreira, Rosário; Silva, Pedro Morais; Ferreira, Tânia Monteiro; Câmara, Raquel; Lobo, Rui; Bordalo, Diana; Guimarães, Cristina; Santo, Maria Espírito; Oliveira, José Ferraz de; Augusto, Maria José Cálix; Gomes, Ricardo; Vieira, Inês; Silva, Sofia da; Marques, Maria; Cardoso, João; Morete, Ana; Aroso, Margarida; Cruz, Ana Margarida; Nunes, Carlos; Câmara, Rita; Rodrigues, Natalina; Abreu, Carmo; Albuquerque, Ana Luísa; Vieira, Claúdia; Santos, Carlos; Páscoa, Rosália; Chaves-Loureiro, Carla; Alves, Adelaide; Neves, Ângela; Marques, José Varanda; Reis, Bruno; Ferreira-Magalhães , Manuel; Fonseca, João AlmeidaHealth and fitness apps have potential benefits to improve self-management and disease control among patients with asthma. However, inconsistent use rates have been reported across studies, regions, and health systems. A better understanding of the characteristics of users and nonusers is critical to design solutions that are effectively integrated in patients’ daily lives, and to ensure that these equitably reach out to different groups of patients, thus improving rather than entrenching health inequities.
- 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.
- Profiling persistent asthma phenotypes in adolescents: A longitudinal diagnostic evaluation from the INSPIRERS StudiesPublication . Amaral, Rita; Jácome, Cristina; Almeida, Rute; Pereira, Ana M.; Alves-Correia, Magna; Mendes, Sandra; Rodrigues, José C.; Carvalho, Joana; Araújo, Luís; Costa, Alberto; Silva, Armandina; Teixeira, Maria F.; Ferreira-Magalhães, Manuel; Alves, Rodrigo R.; Moreira, Ana S.; Fernandes, Ricardo M.; Ferreira, Rosário; Pinto, Paula L.; Neuparth, Nuno; Bordalo, Diana; Bom, Ana T.; Cálix, Maria J.; Ferreira, Tânia; Gomes, Joana; Vidal, Carmen; Mendes, Ana; Vasconcelos, Maria J.; Silva, Pedro M.; Ferraz, José; Morête, Ana; Pinto, Claúdia S.; Santos, Natacha; Loureiro, Carla C.; Câmara, Raquel; Vieira, Inês; Silva, Sofia D.; Silva, Eurico; Rodrigues, Natalina; Fonseca, João A.We aimed to identify persistent asthma phenotypes among adolescents and to evaluate longitudinally asthma-related outcomes across phenotypes. Adolescents (13–17 years) from the prospective, observational, and multicenter INSPIRERS studies, conducted in Portugal and Spain, were included (n = 162). Latent class analysis was applied to demographic, environmental, and clinical variables, collected at a baseline medical visit. Longitudinal differences in clinical variables were assessed at a 4-month follow-up telephone contact (n = 128). Three classes/phenotypes of persistent asthma were identified. Adolescents in class 1 (n = 87) were highly symptomatic at baseline and presented the highest number of unscheduled healthcare visits per month and exacerbations per month, both at baseline and follow-up. Class 2 (n = 32) was characterized by female predominance, more frequent obesity, and uncontrolled upper/lower airways symptoms at baseline. At follow-up, there was a significant increase in the proportion of controlled lower airway symptoms (p < 0.001). Class 3 (n = 43) included mostly males with controlled lower airways symptoms; at follow-up, while keeping symptom control, there was a significant increase in exacerbations/month (p = 0.015). We have identified distinct phenotypes of persistent asthma in adolescents with different patterns in longitudinal asthma-related outcomes, supporting the importance of profiling asthma phenotypes in predicting disease outcomes that might inform targeted interventions and reduce future risk.