{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,3,9]],"date-time":"2026-03-09T18:29:38Z","timestamp":1773080978327,"version":"3.50.1"},"reference-count":16,"publisher":"MDPI AG","issue":"10","license":[{"start":{"date-parts":[[2020,5,15]],"date-time":"2020-05-15T00:00:00Z","timestamp":1589500800000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"funder":[{"name":"undefined  &lt;span style=&quot;color:gray;font-size:10px;&quot;&gt;undefined&lt;\/span&gt;","award":["The study is supported by the  Investigator-Initiated Research Studies Grant - CREARE ( Pfizer)"],"award-info":[{"award-number":["The study is supported by the  Investigator-Initiated Research Studies Grant - CREARE ( Pfizer)"]}]}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["IJERPH"],"abstract":"<jats:p>Objective: To create a mobile application able to help patients follow medical treatments properly. Methods: We designed and developed a custom Android\/iOS App to remind patients of the pharmaceutical drugs to be taken, of the visits and exams to attend, and to detect their compliance with their personal therapeutic plan. In this paper we describe the App development, UX\/UI design, Gamification. TuTOR is an Android and iOS application designed to remind patients of the drugs to be taken, giving them all the information related to their therapeutic plans in a simple and non-invasive way. Thanks to a dedicated back-office, specially designed to meet specific medical information needs, the App can also help physicians detect their patients\u2019 compliance with their treatments and modify prescriptions in real time. The App also ensures a state-of-the-art approach to data security and privacy protection. The main feature of TuTOR is the smart therapy assistant, which features dedicated alarms to remind users of taking their prescription drugs. Thanks to the automatic synchronization with a local database, the alert system works even without connection to the Internet. Particular attention was paid during the App\u2019s design process: we looked to create an intuitive interface to ensure absolute ease of use, with state-of-the-art visual design aimed at maximizing user experience. Other relevant features include the App\u2019s ability to givevisual evidence of the most important drugs to be taken and its note-taking feature, which gives patients the possibility to note down indications on why a specific drug was skipped. The App also keeps track of upcoming medical exams, laboratory tests, and visits on a devoted calendar. It also helps patients by listing therapy contacts, such as physicians\u2019 phone numbers, and indicates all medical references by showing, for example, locations of relevant clinics and pharmacies on a map. Thanks to specific visual progress indicators and an innovative gamification approach, the App encourages users to faithfully follow therapy guidelines. With TuTOR, assessing the therapy\u2019s state of completion is quick and easy.Thanksto the privacy-by-design approach used, all data managed by the system is compliant with the European Privacy Regulation and it is not available to third parties. Expected results: A mobile App for medication adherence might increase objectively and subjectively measured adherence.<\/jats:p>","DOI":"10.3390\/ijerph17103469","type":"journal-article","created":{"date-parts":[[2020,5,15]],"date-time":"2020-05-15T10:53:59Z","timestamp":1589540039000},"page":"3469","update-policy":"https:\/\/doi.org\/10.3390\/mdpi_crossmark_policy","source":"Crossref","is-referenced-by-count":6,"title":["Tailoring Tofacitinib Oral Therapy in Rheumatoid Arthritis: The TuTORApp\u2014A Usability Study"],"prefix":"10.3390","volume":"17","author":[{"ORCID":"https:\/\/orcid.org\/0000-0003-1266-9441","authenticated-orcid":false,"given":"Savino","family":"Sciascia","sequence":"first","affiliation":[{"name":"Center of Research of Immunopathology and Rare Diseases-Coordinating Center of Piemonte and Valle d\u2019Aosta Network for Rare Diseases, and SCDU Nephrology and Dialysis-ERKnet Member, S. Giovanni Bosco Hospital, Department of Clinical and Biological Sciences, 10154 Turin, Italy"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-1941-2606","authenticated-orcid":false,"given":"Massimo","family":"Radin","sequence":"additional","affiliation":[{"name":"Center of Research of Immunopathology and Rare Diseases-Coordinating Center of Piemonte and Valle d\u2019Aosta Network for Rare Diseases, and SCDU Nephrology and Dialysis-ERKnet Member, S. Giovanni Bosco Hospital, Department of Clinical and Biological Sciences, 10154 Turin, Italy"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Irene","family":"Cecchi","sequence":"additional","affiliation":[{"name":"Center of Research of Immunopathology and Rare Diseases-Coordinating Center of Piemonte and Valle d\u2019Aosta Network for Rare Diseases, and SCDU Nephrology and Dialysis-ERKnet Member, S. Giovanni Bosco Hospital, Department of Clinical and Biological Sciences, 10154 Turin, Italy"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Pierluigi","family":"Di Nunzio","sequence":"additional","affiliation":[{"name":"DNDG Srl, 10151 Turin, Italy"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Nicola","family":"Buccarano","sequence":"additional","affiliation":[{"name":"DNDG Srl, 10151 Turin, Italy"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Federico","family":"Di Gregorio","sequence":"additional","affiliation":[{"name":"DNDG Srl, 10151 Turin, Italy"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Milone","family":"Valeria","sequence":"additional","affiliation":[{"name":"Pharmacy Department, S. Giovanni Bosco Hospital, 10154 Turin, Italy"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Sara","family":"Osella","sequence":"additional","affiliation":[{"name":"Pharmacy Department, S. Giovanni Bosco Hospital, 10154 Turin, Italy"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Paola","family":"Crosasso","sequence":"additional","affiliation":[{"name":"Pharmacy Department, S. Giovanni Bosco Hospital, 10154 Turin, Italy"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Marika Denise","family":"Favuzzi","sequence":"additional","affiliation":[{"name":"Center of Research of Immunopathology and Rare Diseases-Coordinating Center of Piemonte and Valle d\u2019Aosta Network for Rare Diseases, and SCDU Nephrology and Dialysis-ERKnet Member, S. Giovanni Bosco Hospital, Department of Clinical and Biological Sciences, 10154 Turin, Italy"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Elena","family":"Rubini","sequence":"additional","affiliation":[{"name":"Center of Research of Immunopathology and Rare Diseases-Coordinating Center of Piemonte and Valle d\u2019Aosta Network for Rare Diseases, and SCDU Nephrology and Dialysis-ERKnet Member, S. Giovanni Bosco Hospital, Department of Clinical and Biological Sciences, 10154 Turin, Italy"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Silvia Grazietta","family":"Foddai","sequence":"additional","affiliation":[{"name":"Center of Research of Immunopathology and Rare Diseases-Coordinating Center of Piemonte and Valle d\u2019Aosta Network for Rare Diseases, and SCDU Nephrology and Dialysis-ERKnet Member, S. Giovanni Bosco Hospital, Department of Clinical and Biological Sciences, 10154 Turin, Italy"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-4475-4117","authenticated-orcid":false,"given":"Simone","family":"Baldovino","sequence":"additional","affiliation":[{"name":"Center of Research of Immunopathology and Rare Diseases-Coordinating Center of Piemonte and Valle d\u2019Aosta Network for Rare Diseases, and SCDU Nephrology and Dialysis-ERKnet Member, S. Giovanni Bosco Hospital, Department of Clinical and Biological Sciences, 10154 Turin, Italy"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Dario","family":"Roccatello","sequence":"additional","affiliation":[{"name":"Center of Research of Immunopathology and Rare Diseases-Coordinating Center of Piemonte and Valle d\u2019Aosta Network for Rare Diseases, and SCDU Nephrology and Dialysis-ERKnet Member, S. Giovanni Bosco Hospital, Department of Clinical and Biological Sciences, 10154 Turin, Italy"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Daniela","family":"Rossi","sequence":"additional","affiliation":[{"name":"Center of Research of Immunopathology and Rare Diseases-Coordinating Center of Piemonte and Valle d\u2019Aosta Network for Rare Diseases, and SCDU Nephrology and Dialysis-ERKnet Member, S. Giovanni Bosco Hospital, Department of Clinical and Biological Sciences, 10154 Turin, Italy"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"1968","published-online":{"date-parts":[[2020,5,15]]},"reference":[{"key":"ref_1","doi-asserted-by":"crossref","first-page":"339","DOI":"10.1592\/phco.30.4.339","article-title":"Meta-analysis of the efficacy and safety of adalimumab, etanercept, and infliximab for the treatment of rheumatoid arthritis","volume":"30","author":"Wiens","year":"2010","journal-title":"Pharmacotherapy"},{"key":"ref_2","doi-asserted-by":"crossref","first-page":"797","DOI":"10.1002\/acr.21664","article-title":"American College of Rheumatology guidelines for screening, treatment, and management of lupus nephritis","volume":"64","author":"Hahn","year":"2012","journal-title":"Arthritis Care Res. (Hoboken)"},{"key":"ref_3","doi-asserted-by":"crossref","first-page":"960","DOI":"10.1136\/annrheumdis-2016-210715","article-title":"EULAR recommendations for the management of rheumatoid arthritis with synthetic and biological disease-modifying antirheumatic drugs: 2016 update","volume":"76","author":"Smolen","year":"2017","journal-title":"Ann. Rheum. Dis."},{"key":"ref_4","doi-asserted-by":"crossref","first-page":"451","DOI":"10.1016\/S0140-6736(12)61424-X","article-title":"Tofacitinib (CP-690,550) in combination with methotrexate in patients with active rheumatoid arthritis with an inadequate response to tumour necrosis factor inhibitors: A randomised phase 3 trial","volume":"381","author":"Burmester","year":"2013","journal-title":"Lancet"},{"key":"ref_5","doi-asserted-by":"crossref","first-page":"495","DOI":"10.1056\/NEJMoa1109071","article-title":"Placebo-Controlled Trial of TofacitinibMonotherapy in Rheumatoid Arthritis","volume":"367","author":"Fleischmann","year":"2012","journal-title":"N. Engl. J. Med."},{"key":"ref_6","doi-asserted-by":"crossref","first-page":"2737","DOI":"10.1002\/1529-0131(200112)44:12<2737::AID-ART460>3.0.CO;2-#","article-title":"High incidence of cardiovascular events in a rheumatoid arthritis cohort not explained by traditional cardiac risk factors","volume":"44","author":"Williams","year":"2001","journal-title":"Arthritis Rheum."},{"key":"ref_7","doi-asserted-by":"crossref","first-page":"1114","DOI":"10.1136\/bmj.39553.670231.25","article-title":"Adherence to prescribed antihypertensive drug treatments: Longitudinal study of electronically compiled dosing histories","volume":"336","author":"Vrijens","year":"2008","journal-title":"BMJ"},{"key":"ref_8","doi-asserted-by":"crossref","first-page":"96","DOI":"10.1007\/BF02600211","article-title":"Patient compliance and medical research: Issues in methodology","volume":"9","author":"Melnikow","year":"1994","journal-title":"J. Gen. Intern. Med."},{"key":"ref_9","doi-asserted-by":"crossref","first-page":"76","DOI":"10.1111\/j.1742-1241.2007.01630.x","article-title":"The significance of compliance and persistence in the treatment of diabetes, hypertension and dyslipidaemia: A review","volume":"62","author":"Cramer","year":"2008","journal-title":"Int. J. Clin. Pract."},{"key":"ref_10","doi-asserted-by":"crossref","first-page":"975","DOI":"10.1177\/2047487315597209","article-title":"Determinants of adherence to evidence-based therapy after acute myocardial infarction","volume":"23","author":"Hamood","year":"2016","journal-title":"Eur. J. Prev. Cardiol."},{"key":"ref_11","doi-asserted-by":"crossref","first-page":"e11","DOI":"10.2196\/mhealth.3048","article-title":"Evaluating user perceptions of mobile medication management applications with older adults: A usability study","volume":"2","author":"Grindrod","year":"2014","journal-title":"JMIR mHealth uHealth"},{"key":"ref_12","doi-asserted-by":"crossref","first-page":"e4446","DOI":"10.1097\/MD.0000000000004446","article-title":"A mobile application improves therapy-adherence rates in elderly patients undergoing rehabilitation","volume":"95","author":"Mertens","year":"2016","journal-title":"Medicine"},{"key":"ref_13","doi-asserted-by":"crossref","first-page":"2569","DOI":"10.1002\/art.27584","article-title":"2010 Rheumatoid arthritis classification criteria: An American College of Rheumatology\/European League Against Rheumatism collaborative initiative","volume":"62","author":"Aletaha","year":"2010","journal-title":"Arthritis Rheum."},{"key":"ref_14","doi-asserted-by":"crossref","first-page":"498","DOI":"10.1002\/art.1780350502","article-title":"The American College of Rheumatology 1991 revised criteria for the classification of global functional status in rheumatoid arthritis","volume":"35","author":"Hochberg","year":"1992","journal-title":"Arthritis Rheum."},{"key":"ref_15","doi-asserted-by":"crossref","first-page":"788","DOI":"10.1016\/j.ijmedinf.2009.08.001","article-title":"Elderly persons\u2019 perception and acceptance of using wireless sensor networks to assist healthcare","volume":"78","author":"Steele","year":"2009","journal-title":"Int. J. Med. Inform."},{"key":"ref_16","doi-asserted-by":"crossref","first-page":"426","DOI":"10.1007\/s11096-009-9296-x","article-title":"The A14-scale: Development and evaluation of a questionnaire for assessment of adherence and individual barriers","volume":"31","author":"Jank","year":"2009","journal-title":"Pharm. World Sci."}],"container-title":["International Journal of Environmental Research and Public Health"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/www.mdpi.com\/1660-4601\/17\/10\/3469\/pdf","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2025,10,11]],"date-time":"2025-10-11T09:29:14Z","timestamp":1760174954000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.mdpi.com\/1660-4601\/17\/10\/3469"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2020,5,15]]},"references-count":16,"journal-issue":{"issue":"10","published-online":{"date-parts":[[2020,5]]}},"alternative-id":["ijerph17103469"],"URL":"https:\/\/doi.org\/10.3390\/ijerph17103469","relation":{},"ISSN":["1660-4601"],"issn-type":[{"value":"1660-4601","type":"electronic"}],"subject":[],"published":{"date-parts":[[2020,5,15]]}}}