Imunoalergologia
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Browsing Imunoalergologia by Author "Abreu, C"
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- Monitoring Adherence to Asthma Inhalers Using the InspirerMundi App: Analysis of Real-World, Medium-Term Feasibility StudiesPublication . Jácome, C; Almeida, R; Pereira, AM; Amaral, R; Vieira-Marques, P; Mendes, S; Alves-Correia, M; Ferreira, JA; Lopes, I; Gomes, J; Araújo, L; Couto, M; Chaves Loureiro, C; Maia Santos, L; Arrobas, A; Valério, M; Todo Bom, A; Azevedo, J; Teixeira, MF; Ferreira-Magalhães, M; Leiria Pinto, P; Pinto, N; Castro Neves, A; Morête, A; Todo Bom, F; Costa, A; Silva, D; Vasconcelos, MJ; Falcão, H; Marques, ML; Mendes, A; Cardoso, J; Cidrais Rodrigues, JC; Oliveira, G; Carvalho, J; Lozoya, C; Santos, N; Menezes, F; Gomes, R; Câmara, R; Rodrigues Alves, R; Moreira, AS; Abreu, C; Silva, R; Bordalo, D; Alves, C; Lopes, C; Taborda-Barata, L; Fernandes, RM; Ferreira, R; Chaves-Loureiro, C; Cálix, MJ; Alves, A; Almeida Fonseca, JBackground: Poor medication adherence is a major challenge in asthma and objective assessment of inhaler adherence is needed. InspirerMundi app aims to monitor inhaler adherence while turning it into a positive experience through gamification and social support. Objective: We assessed the medium-term feasibility of the InspirerMundi app to monitor inhaler adherence in real-world patients with persistent asthma (treated with daily inhaled medication). In addition, we attempted to identify the characteristics of the patients related to higher app use. Methods: Two real-world multicenter observational studies, with one initial face-to-face visit and a 4-month telephone interview, were conducted in 29 secondary care centers from Portugal. During an initial face-to-face visit, patients were invited to use the app daily to register their asthma medication intakes. A scheduled intake was considered taken when patients took a photo of the medication (inhaler, blister, or others) using the image-based medication detection tool. Medication adherence was calculated as the number of doses taken as a percentage of the number scheduled. Interacting with the app ≥30 days was used as the cut-off for higher app use. Results: A total of 114 patients {median 20 [percentile 25 to percentile 75 (P25-P75) 16-36] years, 62% adults} were invited, 107 (94%) installed the app and 83 (73%) completed the 4-month interview. Patients interacted with the app for a median of 18 [3-45] days, translated on a median use rate of 15 [3-38]%. Median inhaler adherence assessed through the app was 34 [4-73]% when considering all scheduled inhalations for the study period. Inhaler adherence assessed was not significantly correlated with self-reported estimates. Median adherence for oral and other medication was 41 [6-83]% and 43 [3-73]%, respectively. Patients with higher app use were slightly older (p = 0.012), more frequently taking medication for other health conditions (p = 0.040), and more frequently prescribed long-acting muscarinic antagonists (LAMA, p = 0.024). After 4 months, Control of Allergic Rhinitis and Asthma Test (CARAT) scores improved (p < 0.001), but no differences between patients interacting with the app for 30 days or less were seen. Conclusions: The InspirerMundi app was feasible to monitor inhaler adherence in patients with persistent asthma. The persistent use of this mHealth technology varies widely. A better understanding of characteristics related to higher app use is still needed before effectiveness studies are undertaken.
- Non-Steroidal Anti-Inflammatory Drug Hypersensitivity in ChildrenPublication . Alves, C; Romeira, AM; Abreu, C; Carreiro-Martins, P; Gomes, E; Leiria-Pinto, PThere are rather few publications about hypersensitivity reactions to non-steroidal anti-inflammatory drugs (NSAID) in the paediatric age. In this study, we aimed to assess the frequency of confirmed NSAID hypersensitivity in children with a previous reported reaction to NSAID in order to investigate the role of the drug provocation test (DPT) in the diagnostic workup and to explore the factors associated with confirmed NSAID hypersensitivity.
- Short and Extended Provocation Tests Have Similar Negative Predictive Value in Non-Immediate Hypersensitivity to Beta-Lactams in ChildrenPublication . Regateiro, FS; Rezende, I; Pinto, N; Abreu, C; Carreiro-Martins, P; Gomes, ERDrug provocation tests (DPTs) are the gold-standard method to diagnose non-immediate hypersensitivity reactions (NIHSR) to beta-lactam antibiotics (BL) in children. Our aim was to compare the negative predictive value (NPV) of one-day (short) DPT versus 3-7 days (extended) DPT for the diagnosis of NIHSR to BL in paediatric age. A secondary aim was to compare confidence on drug re-exposure after short and extended negative DPTs.
- Validation of App and Phone Versions of the Control of Allergic Rhinitis and Asthma Test (CARAT)Publication . Jácome, C; Pereira, AM; Almeida, R; Amaral, R; Correia, MA; Mendes, S; Vieira-Marques, P; Ferreira, JA; Lopes, I; Gomes, J; Vidal, C; López Freire, S; Méndez Brea, P; Arrobas, A; Valério, M; Chaves Loureiro, C; Santos, LM; Couto, M; Araujo, L; Todo Bom, A; Azevedo, JP; Cardoso, J; Emiliano, M; Gerardo, R; Lozoya, C; Pinto, PL; Castro Neves, A; Pinto, N; Palhinha, A; Teixeira, F; Ferreira-Magalhães, M; Alves, C; Coelho, D; Santos, N; Menezes, F; Gomes, R; Cidrais Rodrigues, JC; Oliveira, G; Carvalho, J; Rodrigues Alves, R; Moreira, AS; Costa, A; Abreu, C; Silva, R; Morête, A; Falcão, H; Marques, ML; Câmara, R; Cálix, MJ; Bordalo, D; Silva, D; Vasconcelos, MJ; Fernandes, RM; Ferreira, R; Freitas, P; Lopes, F; Almeida Fonseca, J