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Browsing by Author "Pereira, Ana Margarida"

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  • ARIA 2019: Um Percurso Assistencial Integrado para a Rinite Alérgica em Portugal
    Publication . Fonseca, Joao A; Gomes, Tiago Taveira; Pereira, Ana Margarida; Ferreira, Manuel Branco; Martins, Pedro Carreiro; Correia, Magna Alves; Sousa, Jaime Correia de; Costa, Elísio; Lourenço, Olga; Almeida, Mário Morais; Morête, Ana; Regateiro, Frederico; Bom, Ana Todo; Bachert, Claus; Pfaar, Oliver; Wallace, Dana; Bedbrook, Anna; Czarlewski, Wienczyslawa; Bousquet, Jean
    A iniciativa Allergic Rhinitis and Its Impact on Asthma (ARIA) teve início há mais de 20 anos e tem elaborado e disseminado orientações baseadas em evidência, e desenvolvido projetos na área da rinite alérgica. Esta iniciativa está atualmente focada em proporcionar orientações centradas no doente que contribuam para um percurso integrado entre os vários níveis de cuidados e que tirem partido de soluções digitais, tendo sido recomendada a introdução na prática clínica de percursos assistenciais integrados. Neste artigo descrevemos a adaptação para Portugal do documento ARIA Integrated Care Pathways. Após breve revisão sobre a epidemiologia e o impacto da rinite alérgica em Portugal e das atividades realizadas em Portugal no âmbito da iniciativa ARIA, é descrito o conjunto alargado de conhecimento utilizado para o desenvolvimento das recomendações para o tratamento farmacológico da rinite alérgica, recomendações essas baseadas na metodologia GRADE, evidência do mundo real adquirida por tecnologia móvel (mHealth) e resultante de estudos de câmara de exposição alergénica. Em seguida, são resumidos os percursos assistenciais integrados para imunoterapia com alergénios produzidas em 2019. Considera-se a imunoterapia com alergénios um exemplo de medicina de precisão e em que a utilização de tecnologias mHealth permitirá melhorar a estratificação para seleção dos doentes e monitorização da resposta. Estas recomendações foram consideradas como ‘boas práticas’ dos cuidados integrados centrados no doente apoiados por sistemas digitais da DG Santé (Direção Geral de Saúde e de Segurança Alimentar da União Europeia) e representam a estratégia de gestão da mudança da fase 4 do ARIA.
    2021-02-01Journal article Open access Show more
  • Concepts for the Development of Person-Centered, Digitally Enabled, Artificial Intelligence–Assisted ARIA Care Pathways (ARIA 2024)
    Publication . Bousquet, Jean; Schünemann, Holger; Sousa-Pinto, Bernardo; Zuberbier, Torsten; Togias, Alkis; Samoliński, Bolesław; Bedbrook, Anna; Czarlewski, Wienczyslawa; Hofmann-Apitius, Martin; Litynska, Justyna; Vieira, Rafael José; Giuliano, Antonio F.M.; Gotua, Maia; Gradauskiene, Brigita; Guzman, Maria Antonieta; Hossny, Elham; Hrubiško, Martin; Iinuma, Tomohisa; Irani, Carla; Ispayeva, Zhanat; Ivancevich, Juan Carlos; Anto, Josep M.; Jartti, Tuomas; Jesenak, Milos; Julge, Kaja; Jutel, Marek; Kaidashev, Igor; Bennoor, Kazi Saifuddin; Khaltaev, Nicolai; Kirenga, Bruce; Kraxner, Helga; Kull, Inger; Fonseca, Joao A; Kulus, Marek; Kuna, Piotr; Kupczyk, Maciej; Kurchenko, Andriy; La Grutta, Stefania; Lane, Stephen; Miculinic, Neven; Lee, Sang Min; Le Thi Tuyet, Lan; Lkhagvaa, Battur; Brozek, Jan; Louis, Renaud; Mahboub, Bassam; Mäkelä, Mika J.; Makris, Michael; Maurer, Marcus; Melén, Eric; Milenkovic, Branislava; Mohammad, Yousser; Moniuszko, Marcin; Montefort, Stephen; Bognanni, Antonio; Moreira, Andre; Moreno, Pablo; Mullol, Joaquim; Nadif, Rachel; Nakonechna, Alla; Navarro-Locsin, Cecilia Gretchen; Neffen, Hugo; Nekam, Kristof; Niedoszytko, Marek; Nunes, Elizabete; Brussino, Luisa; Nyembue Tshipukane, Dieudonne; O’Hehir, Robyn; Ollert, Markus; Ohta, Ken; Okamoto, Yoshitaka; Okubo, Kimihiro; Olze, Heidi; Padukudru, Mahesh Anand; Palomares, Oscar; Pali-Schöll, Isabella; Canonica, Giorgio Walter; Panzner, Petr; Palosuo, Kati; Park, Hae-Sim; Passalacqua, Giovanni; Patella, Vincenzo; Pawankar, Ruby; Pétré, Benoît; Pitsios, Constantinos; Plavec, Davor; Popov, Todor A.; Cherrez Ojeda, Ivan; Puggioni, Francesca; Quirce, Santiago; Raciborski, Filip; Ramonaité, Agné; Recto, Marysia; Repka- Ramirez, María Susana; Roberts, Graham; Robles-Velasco, Karla; Roche, Nicolas; Rodriguez-Gonzalez, Monica; Cruz, Alvaro; Romualdez, Joel A.; Rottem, Menachem; Rouadi, Philip; Salapatas, Marianella; Sastre, Joaquin; Serpa, Faradiba; Sayah, Zineb; Scichilone, Nicola; Senna, Gianenrico; Sisul, Juan; Vecillas, Leticia De Las; Solé, Dirceu; Soto-Martinez, Manuel E.; Sova, Milan; Sozinova, Olga; Stevanovic, Katarina; Suppli Ulrik, Charlotte; Szylling, Anna; Tan, Frances M.; Tantilipikorn, Pongsakorn; Bom, Ana Todo; Dykewicz, Mark; Tomic Spiric, Vesna; Tsaryk, Vladyslav; Tsiligianni, Ioanna; Urrutia-Pereira, Marilyn; Valentin Rostan, Marylin; Sofiev, Mikhail; Valovirta, Erkka; Van Eerd, Michiel; Van Ganse, Eric; Vasankari, Tuula; Gemicioglu, Bilun; Vichyanond, Pakit; Viegi, Giovanni; Wallace, Dana; Wang, De Yun; Waserman, Susan; Wong, Gary; Worm, Margitta; Yusuf, Osman; Zaitoun, Fares; Zidarn, Mihaela; Giovannini, Mattia; Haahtela, Tari; Jacobs, Marc; Jacomelli, Cristina; Klimek, Ludger; Kvedarienė, Violeta; Linnemann, Désirée Larenas; Louis, Gilles; Lourenço, Olga; Leemann, Lucas; Almeida, Mario Morais; Neves, Ana Luisa; Nadeau, Kari; Nowak, Artur; Palamarchuk, Yuliia; Palkonen, Susanna; Papadopoulos, Nikolaos G.; Parmelli, Elena; Pereira, Ana Margarida; Pfaar, Oliver; Regateiro, Frederico S.; Savouré, Marine; Barata, Luís Taborda; Toppila-Salmi, Sanna Katriina; Torres, María Jose; Valiulis, Arunas; Ventura, Maria Teresa; Williams, Siân; Yepes-Nuñez, Juan J.; Yorgancıoglu, Arzu; Zhang, Luo; Zuberbier, Jaron; Abdul Latiff, Amir; Abdullah, Baharudin; Agache, Ioana; Al-Ahmad, Mona; Al-Nesf, Maryam A Y; Al Shaikh, A.; Amaral, Rita; Ansotegui Zubeldia, Ignacio Javier; Asllani, Julijana; Balotro-Torres, Maria Cristina; Bergmann, Karl-Christian; Bernstein, Jonathan; Bindslev-Jensen, Carsten; Blaiss, Michael S.; Bonaglia, Cristina; Bonini, Matteo; Bossé, Isabelle; Braido, Fulvio; Caballero-Fonseca, Fernan; Camargos, Paulo; Martins, Pedro Carreiro; Casale, Thomas; Castillo-Vizuete, José-Antonio; Cecchi, Lorenzo; Teixeira, Maria Do Céu; Chang, Yoon-Seok; Loureiro, Cláudia Chaves; Christoff, George; Ciprandi, Giorgio; Cirule, Ieva; Sousa, Jaime Correia De; Costa, Elísio; Cvetkovski, Biljana; De Vries, Govert; Del Giacco, Stefano; Devillier, Philippe; Dokic, Dejan; Douagui, Habib; Durham, Stephen; Enecilla, Maria Lourdes; Fiocchi, Alessandro; Fokkens, Wytske; Fontaine, Jean-François; Gawlik, Radoslaw; Gereda, Jose E.; Mata, Sara Gil
    Abstract The traditional healthcare model is focused on diseases (medicine and natural science) and does not acknowledge patients' resources and abilities to be experts in their own lives based on their lived experiences. Improving healthcare safety, quality, and coordination, as well as quality of life, is an important aim in the care of patients with chronic conditions. Person-centered care needs to ensure that people's values and preferences guide clinical decisions. This paper reviews current knowledge to develop (1) digital care pathways for rhinitis and asthma multimorbidity and (2) digitally enabled, person-centered care.1 It combines all relevant research evidence, including the so-called real-world evidence, with the ultimate goal to develop digitally enabled, patient-centered care. The paper includes (1) Allergic Rhinitis and its Impact on Asthma (ARIA), a 2-decade journey, (2) Grading of Recommendations, Assessment, Development and Evaluation (GRADE), the evidence-based model of guidelines in airway diseases, (3) mHealth impact on airway diseases, (4) From guidelines to digital care pathways, (5) Embedding Planetary Health, (6) Novel classification of rhinitis and asthma, (7) Embedding real-life data with population-based studies, (8) The ARIA-EAACI (European Academy of Allergy and Clinical Immunology) strategy for the management of airway diseases using digital biomarkers, (9) Artificial intelligence, (10) The development of digitally enabled, ARIA person-centered care, and (11) The political agenda. The ultimate goal is to propose ARIA 2024 guidelines centered around the patient to make them more applicable and sustainable.
    2024Journal article Open access Show more
  • Measuring adherence to inhaled control medication in patients with asthma: Comparison among an asthma app, patient self‐report and physician assessment
    Publication . Cachim, Afonso; Pereira, Ana Margarida; Almeida, Rute; Amaral, Rita; Correia, Magna Alves; Marques, Pedro Vieira; Loureiro, Cláudia Chaves; Ribeiro, Carmelita; Cardia, Francisca; Gomes, Joana; Vidal, Carmen; Silva, Eurico; Rocha, Sara; Rocha, Diana; Marques, Maria Luís; Páscoa, Rosália; Morais, Daniela; Cruz, Ana Margarida; Santalha, Marta; Simões, José Augusto Rodrigues; Silva, Sofia da; Silva, Diana; Gerardo, Rita; Bom, Filipa Todo; Morete, Ana; Vieira, Inês; Vieira, Pedro; Monteiro, Rosário; Raimundo, Rosário; Monteiro, Luís; Neves, Ângela; Santos, Carlos; Penas, Ana Margarida; Regadas, Rita; Marques, José Varanda; Rosendo, Inês; Aguiar, Margarida Abreu; Fernandes, Sara; Cardoso, Carlos Seiça; Pimenta, F.; Meireles, Patrícia; Gonçalves, Mariana; Fonseca, Joao A; Jácome, Cristina
    Background Previous studies have demonstrated the feasibility of using an asthma app to support medication management and adherence but failed to compare with other measures currently used in clinical practice. However, in a clinical setting, any additional adherence measurement must be evaluated in the context of both the patient and physician perspectives so that it can also help improve the process of shared decision making. Thus, we aimed to compare different measures of adherence to asthma control inhalers in clinical practice, namely through an app, patient self-report and physician assessment. Methods This study is a secondary analysis of three prospective multicentre observational studies with patients (≥13 years old) with persistent asthma recruited from 61 primary and secondary care centres in Portugal. Patients were invited to use the InspirerMundi app and register their inhaled medication. Adherence was measured by the app as the number of doses taken divided by the number of doses scheduled each day and two time points were considered for analysis: 1-week and 1-month. At baseline, patients and physicians independently assessed adherence to asthma control inhalers during the previous week using a Visual Analogue Scale (VAS 0–100). Results A total of 193 patients (72% female; median [P25–P75] age 28 [19–41] years old) were included in the analysis. Adherence measured by the app was lower (1 week: 31 [0–71]%; 1 month: 18 [0–48]%) than patient self-report (80 [60–95]) and physician assessment (82 [51–94]) (p < 0.001). A negligible non-significant correlation was found between the app and subjective measurements (ρ 0.118–0.156, p > 0.05). There was a moderate correlation between patient self-report and physician assessment (ρ = 0.596, p < 0.001). Conclusions Adherence measured by the app was lower than that reported by the patient or the physician. This was expected as objective measurements are commonly lower than subjective evaluations, which tend to overestimate adherence. Nevertheless, the low adherence measured by the app may also be influenced by the use of the app itself and this needs to be considered in future studies.
    2023-02-15Journal article Open access Show more