Joao A Fonseca

Joao A Fonseca
University of Porto | UP · Center for Research in Health Technologies and Information Systems

MD, PhD

About

412
Publications
106,568
Reads
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9,508
Citations
Introduction
Joao A Fonseca leads the Patient-Centred Innovations and Technologies (PaCeIT) at the Centre for Health Technologies and Services Research (CINTESIS) mainly focused on clinical & Health Services research (mobile health and patient-reported outcome measures for Asthma, allergy and respiratory diseases). He is Head of the Department of Community Medicine Information Decision in Health at Porto University Medical School and of the Allergy Units at CUF Porto and co-founder of MEDIDA, Lda.
Additional affiliations
July 2009 - present
Instituto CUF and Hospital CUF Porto
Position
  • Head Allergy Unit
June 2007 - present
University of Porto

Publications

Publications (412)
Article
Drug repurposing is one of the major fields of Value-Added Medicines. It involves the investigation and evaluation of existing drugs for new therapeutic purposes that address unmet healthcare needs. There are several unmet needs in allergic rhinitis that could be improved by drug repurposing. This could be game-changing for disease management. The...
Article
Background Several studies have suggested an impact of allergic rhinitis on academic productivity. However, large studies with real-world data (RWD) are not available. Objective To use RWD to assess the impact of allergic rhinitis on academic performance (measured through a visual analog scale – VAS education – and the WPAI+CIQ:AS questionnaire),...
Article
Background: Different treatments exist for allergic rhinitis (AR), including pharmacotherapy and allergen immunotherapy (AIT), but they have not been compared using direct patient data (i.e., "real-world data"). Objective: To compare AR pharmacological treatments on (i) daily symptoms, (ii) frequency of use in co-medication, (iii) visual analogu...
Article
Full-text available
Long-term adherence to medication is of critical importance for the successful management of chronic diseases. Objective tools to track oral medication adherence are either lacking, expensive, difficult to access, or require additional equipment. To improve medication adherence, cheap and easily accessible objective tools able to track compliance l...
Article
Background: Many foods have an antioxidant activity, and nutrition may mitigate COVID-19. Some countries with a low COVID-19 mortality have a relatively high consumption of cabbage or fermented foods. To test the potential role of fermented foods and cabbage in COVID-19 mortality in Europe, we performed an ecological study. Methods: The EFSA Compre...
Article
Background: Co-medication is common among patients with allergic rhinitis (AR), but its dimension and patterns are unknown. This is particularly relevant since AR is understood differently across European countries, as reflected by rhinitis-related search patterns in Google Trends. This study aims to assess AR co-medication and its regional patter...
Article
Patients and Public Involvement in every stage of the patient-centred health research cycle is the key to the development of innovative solutions with an impact on patients' care. This protocol describes the development of ConectAR, a network to promote the involvement of patients with asthma and their carers in the health research cycle. This prot...
Article
Full-text available
Vaccination is a highly effective preventive measure against COVID‐19. However, complementary treatments are needed to better control the disease. Fermented vegetables and spices, agonists of the antioxidant transcription factor nuclear factor (erythroid‐derived 2)‐like 2 (Nrf2) and TRPA1/V1 channels (Transient Receptor Potential Ankyrin 1 and Vani...
Article
Background: Only a small number of apps addressing allergic rhinitis patients have been evaluated. This makes their selection difficult. We aimed to introduce a new approach to market research for allergic rhinitis apps, based on the automatic screening of Apple App and Google Play stores. Methods: A JavaScript programme was devised for automati...
Article
Full-text available
Background: Evidence regarding the effectiveness of allergen immunotherapy (AIT) on allergic rhinitis has been provided mostly by randomised controlled trials, with little data from real-life studies. Objective: To compare the reported control of allergic rhinitis symptoms in three groups of users of the MASK-air® app: those receiving sublingual...
Preprint
Objective tools to track medication adherence are lacking. A tool to monitor pill intake that can be implemented in mHealth apps without the need for additional devices was developed. We propose a pill intake detection tool that uses digital image processing to analyze images of a blister to detect the presence of pills. The tool uses the circular...
Article
Objectives: To assess the seroprevalence of SARS-CoV-2 antibodies in municipal employees of Northern Portugal during the first pandemic wave (May-June 2020) and its association with potentially related risk factors for infection. Material and methods: The authors assessed municipal employees of 2 cities in Northern Portugal, in whom serological...
Article
Objectives: To evaluate physician's opinion and availability to participate in mHealth-related clinical studies with patient recruitment and assessment via telemedicine and to identify characteristics associated with the willingness to participate. Methods: Cross-sectional, observational study, based on an anonymous web survey conducted in May-Jun...
Article
Full-text available
BACKGROUND Regulatory bodies have approved five biologics for severe asthma. However, regional differences in accessibility may limit the global potential for personalized medicine. OBJECTIVE To compare global differences in ease-of-access to biologics. METHODS In April 2021, national prescription criteria for omalizumab, mepolizumab, reslizumab,...
Article
Background Validated combined symptom-medication scores (CSMSs) are needed to investigate the effects of allergic rhinitis treatments. This study aimed to use real-life data from the MASK-air® app to generate and validate hypothesis- and data-driven CSMSs. Methods We used MASK-air® data to assess the concurrent validity, test-retest reliability an...
Article
Full-text available
Introdução: Desde o último Inquérito Nacional sobre Asma (2010), o conhecimento da doença, a sua classificação e as opções terapêuticas disponíveis mudaram significativamente. Por outro lado, a evolução das tecnologias de informação e comunicação potencia a utilização de novos métodos de recolha de dados e permite a disponibilização de ferramentas...
Article
Full-text available
Objectives: High-quality data are crucial for guiding decision-making and practising evidence-based healthcare, especially if previous knowledge is lacking. Nevertheless, data quality frailties have been exposed worldwide during the current COVID-19 pandemic. Focusing on a major Portuguese epidemiological surveillance dataset, our study aims to ass...
Article
Full-text available
Patients’ and carers’ views regarding the Portuguese model of home respiratory care were recently described, yet the complementary perspective of healthcare professionals (HCPs) is still to be investigated. Thus, this study explored HCPs experience in the management of patients needing home respiratory therapies (HRT), and their perspective about t...
Article
Introduction Recommendations have been issued to prevent workplace-related SARS-CoV-2 outbreaks. To discuss their impact, we assessed non-healthcare workers of a company which implemented such recommendations from early on. . Material and methods We performed molecular and serological tests to SARS-CoV-2 in workers of a Portuguese electrical compa...
Article
Background.We assessed adherence to treatment and management needs of adults with persistent asthma and their interest in using apps for asthma management. Secondarily, we explored opinions of patients about an app to assess and improve adherence to treatment. Methods. A cross-sectional study was conducted with 40 adults with persistent asthma (49....
Article
Full-text available
Background MASK-air® is an app that supports allergic rhinitis patients in disease control. Users register daily allergy symptoms and their impact on activities using visual analog scales (VASs). We aimed to assess the concurrent validity, reliability, and responsiveness of these daily VASs. Methods Daily monitoring VAS data were assessed in MASK-...
Article
Full-text available
Conventional lung auscultation is essential in the management of respiratory diseases. However, detecting adventitious sounds outside medical facilities remains challenging. We assessed the feasibility of lung auscultation using the smartphone built-in microphone in real-world clinical practice. We recruited 134 patients (median[interquartile range...
Article
Objectives Patients with asthma often suffer from concomitant allergic rhinitis. The Control Test for Asthma and Allergic Rhinitis (CARAT) is a validated tool to assess asthma and rhinitis multimorbidity. Turkish language validity and reliability of CARAT and its compatibility with other scales were evaluated in the study. Methods Patients with as...
Article
Full-text available
Background In contrast to air pollution and pollen exposure, data on the occurrence of the common cold are difficult to incorporate in models predicting asthma hospitalizations. Objective This study aims to assess whether web-based searches on common cold would correlate with and help to predict asthma hospitalizations. Methods We analyzed all ho...
Article
Full-text available
Studies exploring the experience of patients receiving home respiratory therapies (HRT), such as long-term oxygen therapy (LTOT) and home mechanical ventilation (HMV), are still limited. This study focused on patients’ and carers’ experience with LTOT and HMV. An exploratory, cross-sectional qualitative study, using semi-structured focus groups, wa...
Article
Full-text available
Background: Poor medication adherence is a major challenge in asthma and objective assessment of inhaler adherence is needed. InspirerMundi app aims to monitor inhaler adherence while turning it into a positive experience through gamification and social support. Objective: We assessed the medium-term feasibility of the InspirerMundi app to monitor...
Article
BACKGROUND: Clinicians are increasingly recognizing severe asthma patients in whom biologics and other add-on therapies lead to dramatic improvement. Currently, there is no agreedupon super-responder (SR) definition. OBJECTIVE: To survey severe asthma experts using a modified Delphi process, to develop an international consensus-based definition of...
Article
Full-text available
Background: Blood eosinophil (B-Eos) count is an emerging biomarker in the management of respiratory disease but determinants of B-Eos count besides respiratory disease are poorly described. Therefore, we aimed to evaluate the influence of non-respiratory diseases on B-Eos count, in comparison to the effect on two other biomarkers: fraction of exh...
Article
Full-text available
Allergen immunotherapy (AIT), the gradually increasing repeated administration of high doses of allergens to allergic patients, offers the potential for immune tolerance against reactions to the natural exposures to specific allergens. AIT may lead to the long-lasting remission of allergic symptoms and is the only disease-modifying intervention in...
Article
Full-text available
Background Patients with a penicillin allergy label tend to have worse clinical outcomes and increased healthcare use. Drug provocation tests (DPT) are the gold-standard in the diagnostic workup of penicillin allergy, but safety concerns may hinder their performance. We aimed to assess the frequency of severe reactions following a DPT in patients w...
Article
Objective. To estimate the prevalence of self-reported adverse reactions (AdR) to subcutaneous airborne allergen immunotherapy (SCIT) and to describe factors associated with its occurrence. Methods. Real-life, observational, descriptive study of all patients treated with SCIT at a Portuguese allergy unit between 03/2017 and 06/2019, and who answere...
Article
Full-text available
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 o...
Article
Full-text available
Background The practice of allergology varies widely between countries, and the costs and sales for the treatment of rhinitis differ depending on practices and health systems. To understand these differences and their implications, the rhinitis market was studied in some of the EU countries. Methods We conducted a pharmaco‐epidemiological database...
Article
Full-text available
Classification of asthma phenotypes has a potentially relevant impact on the clinical management of the disease. Methods for statistical classification without a priori assumptions (data-driven approaches) may contribute to developing a better comprehension of trait heterogeneity in disease phenotyping. This study aimed to summarize and characteriz...
Article
Older adults, especially men and/or those with diabetes, hypertension and/or obesity, are prone to severe COVID‐19. In some countries, older adults, particularly those residing in nursing homes, have been prioritised to receive COVID‐19 vaccines due to high risk of death. In very rare instances,the COVID‐19 vaccines can induce anaphylaxis, and the...
Article
Full-text available
Background Microdiscectomy is the most commonly performed spine surgery and the first transitioning for outpatient settings. However, this transition was never studied, in what comes to cost-utility assessment. Accordingly, this economic study aims to access the cost-effectiveness of outpatient lumbar microdiscectomy when compared with the inpatien...
Article
Full-text available
Background: Measuring the control of allergic diseases is crucial to assess the outcomes of subcutaneous allergen immunotherapy (SCIT). Objective: To describe the control of allergic diseases (asthma, rhinitis, conjunctivitis) in patients treated with SCIT. Methods: A descriptive study was carried out of all patients aged >12 years under SCIT betwe...
Article
Background Although there are many asymptomatic patients, one of the problems of COVID‐19 is early recognition of the disease. COVID‐19 symptoms are polymorphic and may include upper respiratory symptoms. However, COVID‐19 symptoms may be mistaken withthe common cold or allergic rhinitis. An ARIA‐EAACI study group attempted to differentiate upper r...
Article
Allergen immunotherapy (AIT) is a proven therapeutic option for the treatment of allergic rhinitis and/or asthma. Many international or national practice guidelines have been produced, but the evidence-based method varies and they do not usually propose care pathways. The present paper considers the possible role of mHealth in AIT for allergic rhin...
Article
Edible insects are a unique food source, requiring extensive allergenic risk assessment before its safe introduction in the food market. In a recent systematic review, crustacean allergic subjects were identified as a risk group due to cross-reactivity mainly mediated by tropomyosin and arginine kinase. Immunologic co-sensitisation to house dust mi...
Article
In this article, we propose that differences in COVID-19 morbidity may be associated with transient receptor potential ankyrin 1 (TRPA1) and/or transient receptor potential vanilloid 1 (TRPV1) activation as well as desensitization. TRPA1 and TRPV1 induce inflammation and play a key role in the physiology of almost all organs. They may augment senso...
Article
Background Pollen food allergy syndrome (PFAS) is a frequently underdiagnosed disease due to diverse triggers, clinical presentations, and test results. This is especially relevant in geographic areas with a broad spectrum of pollen sensitization, such as Southern Europe. Objectives To elucidate similarities and differences ofPFAS in nine Southern...
Article
Full-text available
We aimed to identify persistent asthma phenotypes among adolescents and to evaluate longitudinally asthma-related outcomes across phenotypes. Adolescents (13–17 years) from the prospective, observational, and multicenter INSPIRERS studies, conducted in Portugal and Spain, were included (n = 162). Latent class analysis was applied to demographic, en...
Article
Full-text available
We performed a systematic review and diagnostic accuracy meta-analysis, searching on MEDLINE, Scopus, and Web of Science. We included studies conducted in patients reporting a penicillin allergy and in whom skin tests and/or specific IgE quantification were performed and compared with drug challenge results. We quantitatively assessed the accuracy...
Preprint
BACKGROUND In contrast to air pollution and pollen exposure, data on the occurrence of the common cold are difficult to incorporate in models predicting asthma hospitalizations. OBJECTIVE This study aims to assess whether web-based searches on common cold would correlate with and help to predict asthma hospitalizations. METHODS We analyzed all ho...
Preprint
BACKGROUND The COVID-19 pandemic created a golden opportunity for digital health. Nevertheless, studies to validate mHealth solutions are still missing. To expedite those studies while ensuring patient safety, the use of telemedicine technologies for patient recruitment and assessment could be a suitable alternative to traditional study designs wit...
Chapter
This paper aims to summarize and discuss the privacy, security, interactions and safety challenges for the case study of a mobile Health application (mHealth app), for chronic obstructive respiratory diseases, namely AIRDOC - a Smart Mobile Application for Individualized Support and Monitoring of the Respiratory Function and Sounds. mHealth apps cr...
Article
Full-text available
There are large country variations in COVID-19 death rates that may be partly explained by diet. Many countries with low COVID-19 death rates have a common feature of eating large quantities of fermented vegetables such as cabbage and, in some continents, various spices. Fermented vegetables and spices are agonists of the antioxidant transcription...
Preprint
BACKGROUND Poor medication adherence is a major challenge in asthma and objective assessment of inhaler adherence is needed. InspirerMundi app aims to monitor adherence while turning into a positive experience through gamification and social support. OBJECTIVE This study aimed to evaluate the feasibility and acceptability of the InspirerMundi app...
Article
Full-text available
Background 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...
Poster
BACKGROUND The genus Olea is widely represented in the Mediterranean region by the species Olea europaea L., which has two varieties, var. sylvestris (wild olive) which is part of the natural vegetation and the var. europaea, cultivated olive tree primarily for olive oil production. In Portugal, olive growing is an activity of significative import...
Article
Full-text available
Aims: To identify distinct asthma control clusters based on Control of Allergic Rhinitis and Asthma Test (CARAT) and to compare patients’ characteristics among these clusters. Methods: Adults and adolescents (≥13 years) with persistent asthma were recruited at 29 Portuguese hospital outpatient clinics, in the context of two observational studies of...