TY  - JOUR
AU  - Jácome, Cristina
AU  - Almeida, Rute
AU  - Pereira, Ana Margarida
AU  - Amaral, Rita
AU  - Mendes, Sandra
AU  - Alves-Correia, Magna
AU  - Vidal, Carmen
AU  - López Freire, Sara
AU  - Méndez Brea, Paula
AU  - Araújo, Luís
AU  - Couto, Mariana
AU  - Antolín-Amérigo, Darío
AU  - de la Hoz Caballer, Belén
AU  - Barra Castro, Alicia
AU  - Gonzalez-De-Olano, David
AU  - Todo Bom, Ana
AU  - Azevedo, João
AU  - Leiria Pinto, Paula
AU  - Pinto, Nicole
AU  - Castro Neves, Ana
AU  - Palhinha, Ana
AU  - Todo Bom, Filipa
AU  - Costa, Alberto
AU  - Chaves Loureiro, Cláudia
AU  - Maia Santos, Lilia
AU  - Arrobas, Ana
AU  - Valério, Margarida
AU  - Cardoso, João
AU  - Emiliano, Madalena
AU  - Gerardo, Rita
AU  - Cidrais Rodrigues, José Carlos
AU  - Oliveira, Georgeta
AU  - Carvalho, Joana
AU  - Mendes, Ana
AU  - Lozoya, Carlos
AU  - Santos, Natacha
AU  - Menezes, Fernando
AU  - Gomes, Ricardo
AU  - Câmara, Rita
AU  - Rodrigues Alves, Rodrigo
AU  - Moreira, Ana Sofia
AU  - Bordalo, Diana
AU  - Alves, Carlos
AU  - Ferreira, José Alberto
AU  - Lopes, Cristina
AU  - Silva, Diana
AU  - Vasconcelos, Maria João
AU  - Teixeira, Maria Fernanda
AU  - Ferreira-Magalhães, Manuel
AU  - Taborda-Barata, Luís
AU  - Cálix, Maria José
AU  - Alves, Adelaide
AU  - Almeida Fonseca, João
PY  - 2021
DA  - 2021/5/25
TI  - Feasibility and Acceptability of an Asthma App to Monitor Medication Adherence: Mixed Methods Study
JO  - JMIR Mhealth Uhealth
SP  - e26442
VL  - 9
IS  - 5
KW  - mHealth
KW  - smartphone
KW  - technology assessment
KW  - medication adherence
KW  - self-management
KW  - gamification
KW  - patient participation
AB  - Background: Poor 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. Objective: 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). Methods: 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. Results: 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%). Conclusions: 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. 
SN  - 2291-5222
UR  - https://mhealth.jmir.org/2021/5/e26442
UR  - https://doi.org/10.2196/26442
UR  - http://www.ncbi.nlm.nih.gov/pubmed/34032576
DO  - 10.2196/26442
ID  - info:doi/10.2196/26442
ER  -