RESUMO
BACKGROUND: Digital patient-centered interventions may be important tools for improving and promoting social interaction, health, and well-being among older adults. In this regard, we developed a mobile app called DigiAdherence for an older adult population, which consisted of easy-to-access short videos and messages, to improve health-related knowledge among them and prevent common health conditions, such as falls, polypharmacy, treatment adherence, nutritional problems, and physical inactivity. OBJECTIVE: This study aimed to assess the usability and utility of the DigiAdherence app among Portuguese older adults 65 years or older. METHODS: In this pilot noncontrolled quasi-experimental study, older adults who were patients at the primary health care center in Portimão, Portugal, and owned a smartphone or tablet were recruited. Participants were assessed at baseline, given access to the DigiAdherence app for 1 month, and assessed again immediately after 30 days (first assessment) and 60 days after stopping the use of the app (second assessment). App usability and utility (primary outcomes) were analyzed in the first follow-up assessment using a structured questionnaire with 8 items. In the second follow-up assessment, our focus was on knowledge acquired through the app. Secondary outcomes such as treatment adherence and health-related quality of life were also assessed. RESULTS: The study included 26 older adults. Most participants rated the different functionalities of the app positively and perceived the app as useful, attractive, and user-friendly (median score of 6 on a 7-point Likert scale). In addition, after follow-up, participants reported having a sense of security and greater knowledge in preventing falls (16/24, 67%) and managing therapies and polypharmacy (16/26, 62%). CONCLUSIONS: The DigiAdherence mobile app was useful and highly accepted by older adults, who developed more confidence regarding health-related knowledge. INTERNATIONAL REGISTERED REPORT IDENTIFIER (IRRID): RR2-10.2196/29675.
RESUMO
BACKGROUND: People aged ≥65 years are more likely to have health problems related to aging, polypharmacy, and low treatment adherence. Moreover, health literacy levels decrease with increasing age. OBJECTIVE: The aim of this study is to assess an app's utility in promoting health-related knowledge in people aged ≥65 years. METHODS: We developed a simple, intuitive, and video-based app (DigiAdherence) that presents a recipe, nutritional counseling, and content on physical activity, cognitive exercise, motivation to adhere to treatment, fall prevention, and health literacy. A convenience sample of 25 older adults attending the Personalized Health Care Unit of Portimão or the Family Health Unit of Portas do Arade (ACeS Algarve II - Barlavento, ARS Algarve, Portugal) will be recruited. Subjects must be aged ≥65 years, own a smartphone or tablet, be willing to participate, and consent to participate. Those who do not know how to use or do not have a smartphone/tablet will be excluded. Likewise, people with major cognitive or physical impairment as well as those living in a long-term care center will not be included in this study. Participants will have access to the app for 4 weeks and will be evaluated at 3 different timepoints (V0, before they start using the app; V1, after using it for 30 days; and V2, 60 days after stopping using it). After using the app for 30 days, using a 7-point Likert scale, participants will be asked to score the mobile tool's utility in encouraging them to take their medications correctly, improving quality of life, increasing their health-related knowledge, and preventing falls. They will also be asked to assess the app's ease of use and visual esthetics, their motivation to use the app, and their satisfaction with the app. Subjects will be assessed in a clinical interview with a semistructured questionnaire, including questions regarding user experience, satisfaction, the utility of the app, quality of life (EQ-5D-3L instrument), and treatment adherence (Morisky scale). The proportion of participants who considered the app useful for their health at V1 and V2 will be analyzed. Regarding quality of life and treatment adherence perceptions, comparisons will be made between V0 and V1, using the t test for dependent samples. The same comparisons will be made between V0 and V2. RESULTS: This study was funded in December 2019 and authorized by the Executive Board of ACeS Algarve II - Barlavento and by the Ethics Committee of NOVA Medical School (99/2019/CEFCM, June 2020). This protocol was also approved by the Ethics Committee for Health (16/2020, September 2020) and the Executive Board (December 2020) of the Regional Health Administration of the Algarve, IP (Instituto Público). Recruitment was completed in June 2021. CONCLUSIONS: Since the next generation of older adults may have higher digital literacy, information and communication technologies could potentially be used to deliver health-related content to improve lifestyles among older adults. INTERNATIONAL REGISTERED REPORT IDENTIFIER (IRRID): PRR1-10.2196/29675.
RESUMO
Nasal eucoleosis is an uncommonly diagnosed parasitic infection in domestic dogs. Depending on the parasite load, dogs with Eucoleus boehmi may exhibit mild upper respiratory signs such as sneezing and nasal discharge or may not exhibit any clinical signs. The present study describes the case of a 6-year-old male dog, presented with reverse sneezing of 2 months' duration and bilateral nasal serous discharge. The patient had been taking prednisolone for years due to an immune mediated arthritis of the carpal joint. Physical examination, complete blood count, serum chemistry and thoracic radiography were unremarkable. A computed tomography scan of the nasal cavity was compatible with bilateral chronic rhinitis of unknown aetiology. Further investigation by rhinoscopy revealed diffuse erythematous mucosae with several white and serpentine-shaped worms on the turbinates' surface. Morphological identification of the worms collected in situ was performed, revealing filiform nematodes (15-30 mm in length) containing several bipolar plugged and barrel-shaped eggs in their medial segment. The eggs contained a multicellular embryo, a pitted surface and measured 54-60 µm long by 30-35 µm wide. Morphological and morphometric characteristics were consistent with E. boehmi. Treatment with imidacloprid/moxidectin spot-on formulation along with preventing measures to minimise reinfection were prescribed and successfully achieved, as confirmed by negative faecal examinations. To the best of the authors' knowledge, this represents the first report of E. boehmi infection in a dog from Portugal. Nasal eucoleosis appears to be underestimated and should be considered as a differential diagnosis in canids suffering from upper respiratory distress.
