The role of telehealth counselling with mobile self-monitoring on blood pressure reduction among overseas Koreans with high blood pressure in Vietnam

A Situational Analysis of the Impact of the COVID-19 Pandemic on Digital Health Research Initiatives in South Asia

The objective of this paper was to evaluate and compare the quantity and sustainability of digital health initiatives in the South Asia region before and during the COVID-19 pandemic. The study used a two-step methodology of (a) descriptive analysis of digital health research articles published from 2016 to 2021 from South Asia in terms of stratification of research articles based on diseases and conditions they were developed, geography, and tasks wherein the initiative was applied and (b) a simple and replicable tool developed by authors to assess the sustainability of digital health initiatives using experimental or observational study designs. The results of the descriptive analysis highlight the following: (a) there was a 40% increase in the number of studies reported in 2020 when compared to 2019; (b) the three most common areas wherein substantive digital health research has been focused are health systems strengthening, ophthalmic disorders, and COVID-19; and (c) remote consultation, health information delivery, and clinical decision support systems are the top three commonly developed tools. We developed and estimated the inter-rater operability of the sustainability assessment tool ascertained with a Kappa value of 0.806 (±0.088). We conclude that the COVID-19 pandemic has had a positive impact on digital health research with an improvement in the number of digital health initiatives and an improvement in the sustainability score of studies published during the COVID-19 pandemic.

Self-care of hypertension of older adults during COVID-19 lockdown period: a randomized controlled trial

Background

COVID-19 pandemic has aggravated chronic diseases and health disparities especially hypertension because it is more common among vulnerable populations such as older adults.

Objective

This study aimed to examine the effects of a public health nursing intervention plus m-Health applications for hypertension management on enhancing the self-care, systolic and diastolic of blood pressure, and quality of life in older adults during the lockdown period in Jordan.

Methods

A randomized, controlled trial design was performed in Jordan. A total of 120 participants were randomly allocated to three groups (n = 40); interventional group (public health nursing interventions plus m.Health applications) and two control groups (m.Health applications alone group and standard care group).

Results

After 3 months, the interventional group show significantly decreased in systolic blood pressure − 14 (F = 16.74, P = 0.001), greater improvement in self-care maintenance, monitoring, and confidence (+ 30, + 17.75, + 40.27; P < 0.01, respectively) compared to the two control groups. Greater improvement in role limitations due to physical health and due to emotional problems, pain, energy/fatigue, emotional well-being, and social functioning of quality of life (P < 0.05) compared to the standard care group. No statistical significant difference was found in diastolic blood pressure (F = 3.91, P = 0.141), physical functioning (P = 0.613), and general quality of life (P = 0.060).

Conclusions

This study supports the adoption of technology with nursing intervention as a method of supporting continuity of self-management of chronic illness during the pandemic, and its potential implications for future delivery of health care, not just in Jordan, but across the world.

Trial registration

Clinical Trial.gov (ID NCT04992000). Registered August 12, 2021.

Towards Developing a Voice-activated Self-monitoring Application (VoiS) for Adults with Diabetes and Hypertension

The integration of motivational strategies and self-management theory with mHealth tools is a promising approach to changing the behavior of patients with chronic disease. In this manuscript, we describe the development and current architecture of a prototype voice-activated self-monitoring application (VoiS) which is based on these theories. Unlike prior mHealth applications which require textual input, VoiS app relies on the more convenient and adaptable approach of asking users to verbally input markers of diabetes and hypertension control through a smart speaker. The VoiS app can provide real-time feedback based on these markers; thus, it has the potential to serve as a remote, regular, source of feedback to support behavior change. To enhance the usability and acceptability of the VoiS application, we will ask a diverse group of patients to use it in real-world settings and provide feedback on their experience. We will use this feedback to optimize tool performance, so that it can provide patients with an improved understanding of their chronic conditions. The VoiS app can also facilitate remote sharing of chronic disease control with healthcare providers, which can improve clinical efficacy and reduce the urgency and frequency of clinical care encounters. Because the VoiS app will be configured for use with multiple platforms, it will be more robust than existing systems with respect to user accessibility and acceptability.

Acceptability and feasibility of a mobile health application for blood pressure monitoring in rural Uganda

Background

Mobile technologies to improve blood pressure control in resource-limited settings are needed. We adapted and evaluated the acceptability and feasibility of PositiveLinks, a mobile phone application for self-monitoring, social support, and engagement in care for people living with HIV, among patients with hypertension in rural Uganda.

Methods

We enrolled adults on treatment for hypertension at Mbarara Regional Referral Hospital and Mbarara Municipal health center IV, southwestern Uganda. We provided and educated all participants on the use of PositiveLinks application and automated blood pressure monitors. We administered a baseline questionnaire and performed in-depth interviews 30 days later to explore acceptability, feasibility, medication adherence, social support, and blood pressure control.

Results

A total of 37 participants completed the interviews, mean age of 58 years (SD 10.8) and 28 (75.7%) were female. All participants embraced the PositiveLinks mobile app and were enthusiastic about self-monitoring of blood pressure, 35 (94.6%) experienced peer to peer support. Among the 35 participants non-adherent to medications at baseline, 31 had improved medication adherence. All except 1 of the 31(83.8%) who had uncontrolled blood pressure at baseline, had self-reported controlled blood pressure after 30 days of use of PositiveLinks.

Conclusion

Patients with hypertension in rural Uganda embraced the PositiveLinks mobile application and had improved medication adherence, social support, and blood pressure control. Further assessment of cost-effectiveness of the application in blood pressure control in resource-limited settings will be pursued in future studies.

Telemedicine interventions for hypertension management in low- and middle-income countries: A scoping review

Hypertension remains the leading cause of cardiovascular disease worldwide and disproportionately impacts patients living in low- and middle-income countries (LMICs). Telemedicine offers a potential solution for improving access to health care for vulnerable patients in LMICs.

Clinical applications for out-of-office blood pressure monitoring

Hypertension is one of the most common chronic diseases as well as the leading risk factor for cardiovascular disease (CVD). Efficient screening and accurate blood pressure (BP) monitoring are the basic methods of detection and management. However, with developments in electronic technology, BP measurement and monitoring are no longer limited to the physician's office. Epidemiological and clinical studies have documented strong evidence for the efficacy of out-of-office BP monitoring in multiple fields for managing hypertension and CVD. This review discusses applications for out-of-office BP monitoring, including home blood pressure monitoring (HBPM) and ambulatory blood pressure monitoring (ABPM), based on recent epidemiological data and clinical studies regarding the following factors: the detection of abnormal BP phenotypes, namely, white coat hypertension and masked hypertension; stronger ability to determine the prognosis for target organ damage and mortality; better BP control; screening for hypotension; and unique approaches to identifying circadian BP patterns and BP variability.

The Effects of Smartphone Applications on Patients Self-care with Hypertension: A Systematic Review Study

Introduction:

High blood pressure or hypertension is one of the chronic diseases causing other serious diseases and syndromes. Active involvement of the patient in the management of the disease is crucial in improving self-care and clinical outcomes. Mobile technology is nowadays used widely to improve the self-care process in people with chronic diseases such as hypertension.

Aim:

The objective of this study was to provide an overview of the existing research evaluating the impact of mobile applications on the self-care of patients with hypertension.

Methods:

The Scopus and PubMed databases were investigated using a comprehensive search strategy from the beginning of 2010 to 2019. All controlled clinical trial studies as well as quasi-experimental studies used mobile as a device for improving the self-care and conducted on patients with hypertension were included in the study. The studies were reviewed by two independent individuals.

Results:

Out of 1032 studies found, 6 studies were finally reviewed after applying the inclusion criteria. Out of 6 studies reviewed, three studies confirmed the effect of using mobile applications on lowering blood pressure. Other studies reported a decline in blood pressure, while statistically significant were not shown.

Conclusion:

The results showed that mobile apps have positive potential on improving the self-care behavior of patients with hypertension, but the evidences presenting their impact are varied. Different reports for efficiency of mobile phone apps for the self-care modification was due to diverse condition of studies for mobile intervention on the patients with hypertension.

Evaluation of a Telehealth Counseling Program for Expatriates

Background:Health problems for expatriates are common due to their vulnerability to local infectious diseases, psychosocial problems, and chronic diseases, but many problems go largely unmet in this unique population.

Introduction:Telehealth counseling was developed and tested for Korean expatriates. We explored the current status of using telehealth counseling systems and showed its feasibility and acceptability in three countries.

Materials and Methods:This retrospective study was based on the “Development and demonstration of telehealth counseling program for overseas Koreans” project funded by the Korea Health Industry Development Institute. In this project, we established five Digital Healthcare Centers (DHCs): 3 in Vietnam and 1 each in Uzbekistan and Cambodia. We used data from October 2016 to September 2017; descriptive analysis and one-way ANOVA were used to present detailed information.

Results:A total of 442 patients made an appointment for telehealth counseling services. Overall user satisfaction rates were 96.1%. Over two thirds of patients (302/442, 68.3%) completed one-time telehealth counseling. About 13% were referred to primary care, and 17 (3.8%) were referred to specialists or tertiary hospital. The most common diagnostic category was endocrine, nutritional, and metabolic diseases (14%), followed by diseases of the circulatory system (12.3%) for one-time visit patients.

Discussion:Our telehealth counseling program for expatriates was feasible and acceptable in three countries. It also has the potential to minimize language barriers and the cost of healthcare usage.

Conclusion:Further research for sustainable effective telehealth systems for expatriates will be needed.