CINTESIS-Center for Health Technology and Services Research, Faculty of Medicine, University of Porto, Porto, Portugal.
Department of Community Medicine, MEDCIDS, Health Information and Decision, Faculty of Medicine, University of Porto, Porto, Portugal.
Methods Inf Med. 2021 Jun;60(S 01):e9-e19. doi: 10.1055/s-0041-1726277. Epub 2021 Apr 27.
The adherence to inhaled controller medications is of critical importance for achieving good clinical results in patients with chronic respiratory diseases. Self-management strategies can result in improved health outcomes and reduce unscheduled care and improve disease control. However, adherence assessment suffers from difficulties on attaining a high grade of trustworthiness given that patient self-reports of high-adherence rates are known to be unreliable.
Aiming to increase patient adherence to medication and allow for remote monitoring by health professionals, a mobile gamified application was developed where a therapeutic plan provides insight for creating a patient-oriented self-management system. To allow a reliable adherence measurement, the application includes a novel approach for objective verification of inhaler usage based on real-time video capture of the inhaler's dosage counters.
This approach uses template matching image processing techniques, an off-the-shelf machine learning framework, and was developed to be reusable within other applications. The proposed approach was validated by 24 participants with a set of 12 inhalers models.
Performed tests resulted in the correct value identification for the dosage counter in 79% of the registration events with all inhalers and over 90% for the three most widely used inhalers in Portugal. These results show the potential of exploring mobile-embedded capabilities for acquiring additional evidence regarding inhaler adherence.
This system helps to bridge the gap between the patient and the health professional. By empowering the first with a tool for disease self-management and medication adherence and providing the later with additional relevant data, it paves the way to a better-informed disease management decision.
在慢性呼吸系统疾病患者中,坚持使用吸入性控制器药物对于获得良好的临床效果至关重要。自我管理策略可以改善健康结果,减少非计划性护理,并改善疾病控制。然而,由于患者自我报告的高依从率被认为是不可靠的,因此依从性评估存在难以获得高度可信度的问题。
为了提高患者对药物的依从性,并允许卫生专业人员进行远程监测,开发了一个移动游戏化应用程序,其中治疗计划提供了创建以患者为中心的自我管理系统的见解。为了允许进行可靠的依从性测量,该应用程序包括一种新颖的方法,基于对吸入器剂量计数器的实时视频捕获来客观验证吸入器的使用情况。
该方法使用模板匹配图像处理技术、现成的机器学习框架,并被开发为可在其他应用程序中重复使用。该方法通过 24 名参与者对 12 种吸入器模型的一组测试进行了验证。
在对所有吸入器的 79%的注册事件中,以及在葡萄牙三种最广泛使用的吸入器中超过 90%的事件中,测试结果正确识别了剂量计数器的值。这些结果表明,探索移动嵌入式功能以获取有关吸入器依从性的额外证据具有潜力。
该系统有助于弥合患者和卫生专业人员之间的差距。通过为患者提供疾病自我管理和药物依从性的工具,并为后者提供额外的相关数据,为更明智的疾病管理决策铺平了道路。