Evidence map›Paper›PMID 36825517›Full record

ArticleClinical and translational allergy2023

Measuring adherence to inhaled control medication in patients with asthma: Comparison among an asthma app, patient self-report and physician assessment.

Afonso Cachim, Ana Margarida Pereira, Rute Almeida, Rita Amaral, Magna Alves-Correia, Pedro Vieira-Marques, Claudia Chaves-Loureiro, Carmelita Ribeiro, Francisca Cardia, Joana Gomes and 34 more

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Article in Clinical and translational allergy, 2023. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 3 papers.

0numbers the graph read from it
0cells of the map it votes in
3citing papers in PubMed
–field-weighted citation impact
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

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3 · Its place in the literature

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3 citing papers in PubMed.

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4 · The record

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5 · Who and what money

Authors and funding

44 authors.

Afonso CachimFaculty of Medicine, University of Porto, Porto, Portugal.ORCID https://orcid.org/0000-0002-2790-9252
Ana Margarida PereiraCenter for Health Technology and Services Research (CINTESIS), Faculty of Medicine, University of Porto, Porto, Portugal.
Rute AlmeidaCenter for Health Technology and Services Research (CINTESIS), Faculty of Medicine, University of Porto, Porto, Portugal.ORCID https://orcid.org/0000-0001-7755-5002
Rita AmaralCenter for Health Technology and Services Research (CINTESIS), Faculty of Medicine, University of Porto, Porto, Portugal.
Magna Alves-CorreiaCenter for Health Technology and Services Research (CINTESIS), Faculty of Medicine, University of Porto, Porto, Portugal.
Pedro Vieira-MarquesCenter for Health Technology and Services Research (CINTESIS), Faculty of Medicine, University of Porto, Porto, Portugal.
Claudia Chaves-LoureiroPulmonology Department, Hospitais da Universidade de Coimbra, Centro Hospitalar e Universitário de Coimbra, Coimbra, Portugal.
Carmelita RibeiroServiço Imunoalergologia, Centro Hospitalar e Universitário de Coimbra, Coimbra, Portugal.
Francisca CardiaUnidade de Saúde Familiar (USF) Terras de Azurara, Agrupamento de Centros de Saúde Dão Lafões, Mangualde, Portugal.
Joana GomesServiço de Imunoalergologia, Unidade I, Centro Hospitalar Vila Nova de Gaia/Espinho, Vila Nova de Gaia, Portugal.
Carmen VidalServicio de Alergia, Complejo Hospitalario Universitario de Santiago, Santiago de Compostela, Spain.
Eurico SilvaUSF João Semana, Agrupamento de Centros de Saúde (ACES) Baixo Vouga, Ovar, Portugal.
Sara RochaUSF Arte Nova, ACES Baixo Vouga, Oliveirinha, Portugal.
Diana RochaUSF Sá de Miranda, ACES Cávado II - Gerês/Cabreira, Vila Verde, Portugal.
Maria Luís MarquesServiço de Imunoalergologia, Hospital da Senhora da Oliveira, Guimarães, Portugal.
Rosália PáscoaCenter for Health Technology and Services Research (CINTESIS), Faculty of Medicine, University of Porto, Porto, Portugal.
Daniela MoraisUSF Corgo, ACES Douro I - Marão e Douro Norte, Vila Real, Portugal.
Ana Margarida CruzUSF Bom Porto, ACES Grande Porto V - Porto Ocidental, Porto, Portugal.
Marta SantalhaServiço de Pediatria, Hospital da Senhora da Oliveira, Guimarães, Portugal.
José Augusto SimõesCenter for Health Technology and Services Research (CINTESIS), Faculty of Medicine, University of Porto, Porto, Portugal.
Sofia da SilvaUSF Cuidarte, Unidade Local de Saúde do Alto Minho, Portuzelo, Portugal.
Diana SilvaFaculty of Medicine, University of Porto, Porto, Portugal.
Rita GerardoServiço de Pneumologia, Hospital Santa Marta, Centro Hospitalar Universitário de Lisboa Central, Lisboa, Portugal.
Filipa Todo BomServiço de Pneumologia, Hospital Beatriz Ângelo, Loures, Portugal.
Ana MoreteAllergy Unit, Instituto and Hospital CUF-Porto, Porto, Portugal.
Inês VieiraUnidade de Cuidados Saúde Personalizados Arnaldo Sampaio, ACES Pinhal Litoral, Leiria, Portugal.
Pedro VieiraUSF Mondego, ACES Baixo Mondego, Coimbra, Portugal.
Rosário MonteiroCenter for Health Technology and Services Research (CINTESIS), Faculty of Medicine, University of Porto, Porto, Portugal.
Maria Rosário RaimundoUSF Marquês, ACES Pinhal Litoral, Pombal, Portugal.
Luís MonteiroCenter for Health Technology and Services Research (CINTESIS), Faculty of Medicine, University of Porto, Porto, Portugal.
Ângela NevesUSF Araceti, ACES Baixo Mondego, Arazede, Portugal.
Carlos SantosUSF Santo António, ACES Cávado III - Barcelos/Esposende, Barcelos, Portugal.
Ana Margarida PenasUSF Baltar, ACES Tâmega II - Vale do Sousa Sul, Baltar, Portugal.
Rita RegadasUSF Aquilino Ribeiro, ACES Douro II - Douro Sul, Moimenta da Beira, Portugal.
José Varanda MarquesUSF Viseu-Cidade, ACES do Dão Lafões, Viseu, Portugal.
Inês RosendoCenter for Health Technology and Services Research (CINTESIS), Faculty of Medicine, University of Porto, Porto, Portugal.
Margarida Abreu AguiarUSF Valongo, ACES Grande Porto III - Maia/Valongo, Valongo, Portugal.
Sara FernandesUCSP São João da Pesqueira, ACES Douro Sul, São João da Pesqueira, Portugal.
Carlos Seiça CardosoCenter for Health Technology and Services Research (CINTESIS), Faculty of Medicine, University of Porto, Porto, Portugal.
Filipa PimentaUCSP Figueira da Foz Sul, ACES Baixo Mondego, Lavos, Portugal.
Patrícia MeirelesUSF Almedina, ACES Douro II - Douro Sul, Lamego, Portugal.
Mariana GonçalvesUSF Antonina, ACES Ave/Famalicão, Requião, Portugal.
João Almeida FonsecaCenter for Health Technology and Services Research (CINTESIS), Faculty of Medicine, University of Porto, Porto, Portugal.
Cristina JácomeCenter for Health Technology and Services Research (CINTESIS), Faculty of Medicine, University of Porto, Porto, Portugal.

Funding

COMPETE2020European Regional Development Fund POCI-01-0145-36 FEDER-029130Fundação para a Ciência e a Tecnologia UIDB/4255/2020
6 · The paper itself

Abstract

backgroundPrevious studies have demonstrated the feasibility of using an asthma app to support medication management and adherence but failed to compare with other measures currently used in clinical practice. However, in a clinical setting, any additional adherence measurement must be evaluated in the context of both the patient and physician perspectives so that it can also help improve the process of shared decision making. Thus, we aimed to compare different measures of adherence to asthma control inhalers in clinical practice, namely through an app, patient self-report and physician assessment.

methodsThis study is a secondary analysis of three prospective multicentre observational studies with patients (≥13 years old) with persistent asthma recruited from 61 primary and secondary care centres in Portugal. Patients were invited to use the InspirerMundi app and register their inhaled medication. Adherence was measured by the app as the number of doses taken divided by the number of doses scheduled each day and two time points were considered for analysis: 1-week and 1-month. At baseline, patients and physicians independently assessed adherence to asthma control inhalers during the previous week using a Visual Analogue Scale (VAS 0-100).

resultsA total of 193 patients (72% female; median [P25-P75] age 28 [19-41] years old) were included in the analysis. Adherence measured by the app was lower (1 week: 31 [0-71]%; 1 month: 18 [0-48]%) than patient self-report (80 [60-95]) and physician assessment (82 [51-94]) (p < 0.001). A negligible non-significant correlation was found between the app and subjective measurements (ρ 0.118-0.156, p > 0.05). There was a moderate correlation between patient self-report and physician assessment (ρ = 0.596, p < 0.001).

conclusionsAdherence measured by the app was lower than that reported by the patient or the physician. This was expected as objective measurements are commonly lower than subjective evaluations, which tend to overestimate adherence. Nevertheless, the low adherence measured by the app may also be influenced by the use of the app itself and this needs to be considered in future studies.

Indexed as

asthmaclinical decision support systemseHealthmedication adherencemHealthmobile appspatient participationself-managementsmartphonetechnology assessment

Identifiers

PMID36825517
PMCPMC9930432

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