Feasibility and Acceptability of an Asthma App to Monitor Medication Adherence: Mixed Methods Study

Abstract

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.

Determinants of the Use of Health and Fitness Mobile Apps by Patients With Asthma: Secondary Analysis of Observational Studies

“…The other needed variables, such as the ones related to asthma control, were not significant in explaining mHealth behaviors, although they showed a similar trend to the one observed with the variable depression. This is in line with previous asthma mHealth studies showing that patients with worse asthma control engage less with the tested apps [ 15 , 38 ]. Regarding age, odds ratios were higher for patients aged 18-30 years (1.93, 95%CI 0.97-3.89), but no significant differences were detected, despite the P value being close to the significance threshold ( P =.06).…”

Applicability of the MASK-Air® App to Severe Asthma Treated with Biologic Molecules: A Pilot Study

“…However, there was no correlation between adherence to the application and to medications (overall, high medication adherence was recorded, with a median of 91.8%). Although mHealth applications targeting medication adherence may be useful tools for helping patients take their medications as prescribed [ 25 , 26 , 27 ], the current MASK-air ® features have not yet been designed to improve adherence. This will be available when MASK-air becomes a class 2A medical device.…”

ConectAR: Collaborative network of patients with asthma and carers actively involved in health research: a protocol for patient and public involvement

“…T1.1 Invitation to potential patients' representatives as members. This subtask will identify potential interested members (patients/carers) to integrate the network, through initial contacts with patients (>600 from previous studies that gave authorization to be contacted for future studies) and physicians (>275 physicians from 75 different centres) collaborating with our research group (PaCeIT-Patient Centered Innovation and Technologies) (19,20). Portuguese patients' and carers' associations (Associação Portuguesa de Asmáticos, Respira, Associação Nacional Cuidadores Informais) and scientific societies and networks (Sociedade Portuguesa de Alergologia e Imunologia Clínica, Sociedade Portuguesa de Pneumologia, Fundação Portuguesa do Pulmão, Rede de Especialistas em Asma Grave) will be also contacted for the nomination of patients' representatives to join ConectAR.…”