Browsing by Author "Gomes, R"
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- Deficiência de desidrogenase do piruvato: achados em ressonância magnética neonatalPublication . Fernandes, JS; Gomes, R; Cruz, R; Ribeiro, M; Magalhães, Z; Rocha, J
- Feasibility and Acceptability of an Asthma App to Monitor Medication Adherence: Mixed Methods StudyPublication . Jácome, C; Almeida, R; Pereira, AM; Amaral, R; Mendes, S; Alves-Correia, M; Vidal, C; López Freire, S; Méndez Brea, P; Araújo, L; Couto, M; Antolín-Amérigo, D; de la Hoz Caballer, B; Barra Castro, A; Gonzalez-De-Olano, D; Todo Bom, A; Azevedo, J; Leiria Pinto, P; Pinto, N; Castro Neves, A; Palhinha, A; Todo Bom, F; Costa, A; Chaves Loureiro, C; Maia Santos, L; Arrobas, A; Valério, M; Cardoso, J; Emiliano, M; Gerardo, R; Cidrais Rodrigues, JC; Oliveira, G; Carvalho, J; Mendes, A; Lozoya, C; Santos, N; Menezes, F; Gomes, R; Câmara, R; Rodrigues Alves, R; Moreira, AS; Bordalo, D; Alves, C; Ferreira, JA; Lopes, C; Silva, D; Vasconcelos, MJ; Teixeira, MFa; Ferreira-Magalhães, M; Taborda-Barata, L; Cálix, MJ; Alves, A; Almeida Fonseca, JBackground: 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.
- Undernutrition in institutionalized elderly patients with neurological diseases: comparison between different diagnostic criteriaPublication . Miranda, Diana; Cardoso, Rita; Gomes, R; Guimarães, Isabel; Abreu, Daisy; Godinho, C; Pereira, P; Domingos, Josefa; Pona, N; Ferreira, JoaquimObjectives: To determine and compare the frequency of undernutrition in institutionalized elderly patients with neurological diseases at admission using different nutritional assessment tools. Design: Cross-sectional observational study. Setting: One long-term care institution specialized in neurodegenerative diseases. Participants: 92 Elderly people (aged ≥ 65 years) with at least one neurological condition. Measurements: Mini Nutritional Assessment (MNA), body mass index (BMI), mid-arm (MAC) and calf circumferences (CC) were used for nutritional status assessment. Presence and severity of dysphagia, polypharmacy and feeding difficulties were also assessed. Results: According to MNA, 77.1% of the participants were undernourished at admission. BMI identified 46.8%, MAC identified 44.6% and CC identified 22.8% of undernourished participants. Undernutrition was more frequent in Alzheimer’s disease, stroke and dementia syndromes. 63% had dysphagia for at least one food consistence and most of these patients were malnourished. MNA revealed best concordance with BMI and MAC than with CC. BMI and feeding difficulties were the major risk factors for undernutrition. Conclusion: Undernutrition prevalence in institutionalized elderly with neurological diseases at admission is high. Nutritional assessment tools revealed low concordance between them.