1 - Center for Health Technology and Services Research (CINTESIS), Faculty of Medicine, University of Porto, Porto, Portugal
2 - Department of Community Medicine, Information and Health Decision Sciences (MEDCIDS), Faculty of Medicine, University of Porto, Porto, Portugal
3 - Dept. of Cardiovascular and Respiratory Sciences, Porto Health School, Polytechnic Institute of Porto, Porto, Portugal
4 - Allergy Unit, Instituto and Hospital CUF, Porto, Portugal
5 - Servicio de Alergia, Complejo Hospitalario Universitario de Santiago, Santiago De Compostela, Spain
6 - Servicio de Alergia, Hospital Universitario Ramón y Cajal, Madrid, Spain
7 - Serviço de Imunoalergologia, Centro Hospitalar e Universitário de Coimbra, Coimbra, Portugal
8 - Imunoalergologia, Centro Hospitalar de Leiria, Leiria, Portugal
9 - Serviço de Imunoalergologia, Hospital de Dona Estefânia, Centro Hospitalar Universitário de Lisboa Central, Lisboa, Portugal
10 - Pathophysiology, CHRC, Environmental Health research group, CEDOC, NOVA Medical School / Faculdade de Ciências Médicas, Lisboa, Portugal
11 - Serviço de Pneumologia, Hospital Beatriz Ângelo, Loures, Portugal
12 - Serviço de Pediatria, Hospital da Senhora da Oliveira, Guimarães, Portugal
13 - Serviço de Pneumologia, Centro Hospitalar e Universitário de Coimbra, Coimbra, Portugal
14 - Serviço de Pneumologia, Hospital Santa Marta, Centro Hospitalar Universitário de Lisboa Central, Lisboa, Portugal
15 - Serviço de Pediatria, Hospital Pedro Hispano, Unidade Local de Saúde de Matosinhos, Matosinhos, Portugal
16 - Serviço de Imunoalergologia, Hospital de Santa Maria, Centro Hospitalar Universitário Lisboa Norte, Lisboa, Portugal
17 - Serviço de Imunoalergologia, Hospital Amato Lusitano, Unidade Local de Saúde de Castelo Branco, Castelo Branco, Portugal
18 - Serviço de Imunoalergologia, Centro Hospitalar Universitário do Algarve, Portimão, Portugal
19 - Serviço de Pneumologia, Hospital Garcia de Orta, Almada, Portugal
20 - Serviço de Imunoalergologia, Serviço de Saúde da Região Autónoma da Madeira, Funchal, Portugal
21 - Unidade de Imunoalergologia, Hospital do Divino Espirito Santo, Ponta Delgada, Portugal
22 - Serviço de Pediatria, Unidade Hospitalar de Famalicão, Centro Hospitalar do Médio Ave, Vila Nova de Famalicão, Portugal
23 - Serviço de Pneumologia, Hospital Nossa Senhora do Rosário, Centro Hospitalar Barreiro Montijo, Barreiro, Portugal
24 - Serviço de Imunoalergologia, Unidade I, Centro Hospitalar Vila Nova de Gaia/Espinho, Vila Nova De Gaia, Portugal
25 - Unidade de Imunoalergologia, Hospital Pedro Hispano, Unidade Local de Saúde de Matosinhos, Matosinhos, Portugal
26 - Serviço de Imunoalergologia, Centro Hospitalar Universitário de São João, Porto, Portugal
27 - Serviço de Pediatria, Centro Materno Infantil do Norte, Centro Hospitalar Universitário do Porto, Porto, Portugal
28 - Serviço de Imunoalergologia, Hospital Pêro da Covilhã, Centro Hospitalar Universitário Cova da Beira, Covilhã, Portugal
29 - Serviço de Pediatria, Hospital de São Teotónio, Centro Hospitalar Tondela–Viseu, Viseu, Portugal
30 - Serviço de Pneumologia, Unidade I, Centro Hospitalar Vila Nova de Gaia/Espinho, Vila Nova de Gaia, Vila Nova De Gaia, Portugal
31 - MEDIDA – Medicina, Educação, Investigação, Desenvolvimento e Avaliação, Porto, Portugal
- EAACI Digital Congress Allergy 2020; 75 (S109): 372-373.
Background: InspirerMundi app aims to transform adherence into a positive experience through gamification and social support, while allowing objective monitoring of inhaler adherence. This study assessed the feasibility of the app in adolescents and adults with persistent asthma.
Method: A multicentre observational study with an initial face-to-face visit and two phone interviews was conducted in 26 hospital outpatient clinics from Portugal and Spain. Patients were invited to use the app daily and register: medication and respective adherence (scheduled intakes were considered taken when patients presented the inhaler to an image detection tool), need for relief medication and healthcare use, daily/weekly symptom questionnaires and the Control of Allergic Rhinitis and Asthma Test-CARAT. To stimulate engagement, the app included a gamification component (point and badge system with a storyline of evolving from an asthma warrior to an Inspirer-advanced player that can motivate warriors to improve adherence). At 1-month interview, app satisfaction was assessed on a 1-5 scale.
Results: A total of 107 patients (29±13(13-70) years) were recruited and 79(74%) completed the 1-month interview. Ninety-nine (93%) installed the app and interacted with the app a median[P25-P75] of 10[2-25] days, corresponding to a usage rate of 32[6-81]%. Seventy-four patients registered ≥1 scheduled medication: inhaler (n=73), pill (n=35) and others (n=22). Median inhaler adherence tracked by the app was 75[25-90]%; 17 patients registered the use of relief medication, two reported emergency department visits and one an unscheduled medical appointment. Sixty-one patients answered ≥1 CARAT, 40 ≥3 weekly symptom and 21 ≥10 daily symptom questionnaires; 75 received ≥1 badge, 62 achieved ≥1000 points and 6 became Inspirers. Patients were highly satisfied with the app (75% scored ≥4); the features of inhaler image detection tool (53% ≥4) and the social interaction (37% ≥4) presented lower scores. Furthermore, 77% stated that they would recommend the InspirerMundi app to other patients and 53% that the app motivated them to better adhere to inhaled medication.
Conclusion: InspirerMundi app was feasible and acceptable for patients with persistent asthma from 26 hospital outpatient clinics. Based on the results of this study, improvements on the app were implemented including the redesign of the inhaler image detection tool. Additional studies regarding the app usage in other populations and on the app magnitude of effect are required.
Palavras Chave: Asthma; Asthma management