Pedro, Vieira-MarquesRute, AlmeidaTeixeira, João F.Valente, JoséJácome, CristinaCachim, AfonsoGuedes, RuiPereira, AnaJacinto, TiagoFonseca, João A.2021-07-062021-07-062021-04-27Vieira-Marques, P., Almeida, R., Teixeira, J. F., Valente, J., Jácome, C., Cachim, A., Guedes, R., Pereira, A., Jacinto, T., & Fonseca, J. A. (2021). InspirerMundi-Remote Monitoring of Inhaled Medication Adherence through Objective Verification Based on Combined Image Processing Techniques. Methods Inf Med. https://doi.org/10.1055/s-0041-17262770026-1270http://hdl.handle.net/10400.22/18087The adherence to inhaled controller medications is of critical importance for achieving good clinical results in patients with chronic respiratory diseases. Self-management strategies can result in improved health outcomes and reduce unscheduled care and improve disease control. However, adherence assessment suffers from difficulties on attaining a high grade of trustworthiness given that patient self-reports of high-adherence rates are known to be unreliable. Objective Aiming to increase patient adherence to medication and allow for remote monitoring by health professionals, a mobile gamified application was developed where a therapeutic plan provides insight for creating a patient-oriented self-management system. To allow a reliable adherence measurement, the application includes a novel approach for objective verification of inhaler usage based on real-time video capture of the inhaler's dosage counters. This approach uses template matching image processing techniques, an off-the-shelf machine learning framework, and was developed to be reusable within other applications. The proposed approach was validated by 24 participants with a set of 12 inhalers models. Results Performed tests resulted in the correct value identification for the dosage counter in 79% of the registration events with all inhalers and over 90% for the three most widely used inhalers in Portugal. These results show the potential of exploring mobile-embedded capabilities for acquiring additional evidence regarding inhaler adherence. This system helps to bridge the gap between the patient and the health professional. By empowering the first with a tool for disease self-management and medication adherence and providing the later with additional relevant data, it paves the way to a better-informed disease management decision.engMedication adherencemHealthRemote monitoringSerious gamesjournal article10.1055/s-0041-1726277