InspirerMundi—Remote Monitoring of Inhaled Medication Adherence through Objective Verification Based on Combined Image Processing Techniques

Pedro Vieira-Marques; Rute Almeida; João F. Teixeira; José Valente; Cristina Jácome; Afonso Cachim; Rui Guedes; Ana Pereira; Tiago Jacinto; João A. Fonseca

doi:10.1055/s-0041-1726277

Methods of Information in Medicine, Table of Contents

CC BY-NC-ND 4.0 · Methods Inf Med 2021; 60(S 01): e9-e19
DOI: 10.1055/s-0041-1726277

Original Article

InspirerMundi—Remote Monitoring of Inhaled Medication Adherence through Objective Verification Based on Combined Image Processing Techniques

Pedro Vieira-Marques

¹CINTESIS—Center for Health Technology and Services Research, Faculty of Medicine, University of Porto, Porto, Portugal

,

Rute Almeida

¹CINTESIS—Center for Health Technology and Services Research, Faculty of Medicine, University of Porto, Porto, Portugal

²Department of Community Medicine, MEDCIDS, Health Information and Decision, Faculty of Medicine, University of Porto, Porto, Portugal

,

João F. Teixeira

³INESC TEC, Porto, Portugal

,

José Valente

⁴MEDIDA—Serviços em Medicina, EDucação, Investigação, Desenvolvimento e Avaliação, LDA, Porto, Portugal

,

Cristina Jácome

¹CINTESIS—Center for Health Technology and Services Research, Faculty of Medicine, University of Porto, Porto, Portugal

²Department of Community Medicine, MEDCIDS, Health Information and Decision, Faculty of Medicine, University of Porto, Porto, Portugal

,

Afonso Cachim

²Department of Community Medicine, MEDCIDS, Health Information and Decision, Faculty of Medicine, University of Porto, Porto, Portugal

,

Rui Guedes

²Department of Community Medicine, MEDCIDS, Health Information and Decision, Faculty of Medicine, University of Porto, Porto, Portugal

,

Ana Pereira

¹CINTESIS—Center for Health Technology and Services Research, Faculty of Medicine, University of Porto, Porto, Portugal

²Department of Community Medicine, MEDCIDS, Health Information and Decision, Faculty of Medicine, University of Porto, Porto, Portugal

⁵Allergy Unit, Instituto and Hospital CUF, Porto, Portugal

,

Tiago Jacinto

¹CINTESIS—Center for Health Technology and Services Research, Faculty of Medicine, University of Porto, Porto, Portugal

⁴MEDIDA—Serviços em Medicina, EDucação, Investigação, Desenvolvimento e Avaliação, LDA, Porto, Portugal

⁶Department of Cardiovascular and Respiratory Sciences, Porto Health School, Polytechnic Institute of Porto, Porto, Portugal

,

João A. Fonseca

¹CINTESIS—Center for Health Technology and Services Research, Faculty of Medicine, University of Porto, Porto, Portugal

²Department of Community Medicine, MEDCIDS, Health Information and Decision, Faculty of Medicine, University of Porto, Porto, Portugal

⁴MEDIDA—Serviços em Medicina, EDucação, Investigação, Desenvolvimento e Avaliação, LDA, Porto, Portugal

⁵Allergy Unit, Instituto and Hospital CUF, Porto, Portugal

› Author Affiliations

Abstract

Background 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.

Objective 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.

Methods 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.

Results 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.

Conclusion 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.

Keywords

medication adherence - mHealth - remote monitoring - serious games

Full Text

References

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