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Litvin CB, Ornstein SM. Development and Initial Use of an Evidence-Based Home Blood Pressure Monitoring mHealth Platform. J Med Syst 2023; 47:53. [PMID: 37118616 DOI: 10.1007/s10916-023-01955-y] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/14/2023] [Accepted: 04/19/2023] [Indexed: 04/30/2023]
Abstract
Home blood pressure monitoring (HBPM) has been shown to provide a more reliable assessment of blood pressure (BP) than in-office measurement and may lead to improved BP control. While many mHealth apps are available to help users track their blood pressure (BP), no apps incorporate the full set of evidence-based HBPM recommendations for ensuring accurate measurement at home. Through an agile development approach employing user stories, we translated an evidence-based standardized protocol for BP measurement and monitoring over a recommended 3-7 day monitoring period into a mHealth app and corresponding clinician portal. We then pilot tested this platform to assess its feasibility for guiding users to measure BP over multiple days according to this protocol. During this pilot testing, one hundred and twenty five users created an app account; 75 (60.0%) of these users recorded at least one BP reading and 47 (37.6%) completed at least one monitoring period. Through this work, we have demonstrated how a series of guidelines can be systematically translated into a mHealth platform for HBPM. Such platforms may be accessible resources to facilitate standardized HBPM and sharing of readings with providers.
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Affiliation(s)
- Cara B Litvin
- Division of General Internal Medicine, Department of Medicine, Medical University of South Carolina, 135 Rutledge Ave, 12th floor, Charleston, SC, 29425, USA.
| | - Steven M Ornstein
- Division of General Internal Medicine, Department of Medicine, Medical University of South Carolina, 135 Rutledge Ave, 12th floor, Charleston, SC, 29425, USA
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Kaur M, Kaur H, Rathi S, Ashwitha M, Joanna J, Reddy S, Idris B, Myrtle P, Kandamuru S, Fatima S, Joshi A. Apps on Google Play Store to assist in self-management of hypertension in Indian context: features analysis study. Mhealth 2022; 8:14. [PMID: 35449503 PMCID: PMC9014236 DOI: 10.21037/mhealth-21-25] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/22/2021] [Accepted: 10/14/2021] [Indexed: 11/06/2022] Open
Abstract
BACKGROUND A large number of individuals with hypertension are turning to the Internet and m-health technologies for assistance. There is a need to study the content of smartphone applications on hypertension. The study aimed to review and investigate the functional and analytical characteristics of apps related to the self-management of hypertension available on Google Play Store. METHODS Search was conducted in February 2021 in India using the Google Play Store database to identify currently available Android-based apps related to self-management of hypertension/high blood pressure (BP). Keywords used were: 'Hypertension', 'High blood pressure', 'DASH diet', 'Hypertension diet', and 'Blood pressure diet'. A total of 822 apps were screened based on the duplicates, inclusion, and exclusion criteria. A total of 210 were included for further analysis. RESULTS Eighteen percent (n=37) of the apps had an overall rating of 4.5 or above. About 41% of the apps belonged to the medical category and 41% of the apps were characterized in the health and fitness category. Feature of logging/recording the BP measurement was seen in 73% of the apps. In-app graphing to analyze BP trends was reported in 64 % of the included apps. A few apps focused on tracking medication (n=19), sodium intake (n=2), and calorie intake (n=4). CONCLUSIONS The features were common across all the included apps and were focusing only on recording the BP, providing statistics and trends of BP, and providing educational information. App developers should now aim to provide other components of self-management techniques to help individuals tackle hypertension.
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Affiliation(s)
- Mahima Kaur
- Foundation of Healthcare Technologies Society, New Delhi, Delhi, India
| | - Harpreet Kaur
- Foundation of Healthcare Technologies Society, New Delhi, Delhi, India
| | - Surbhi Rathi
- Foundation of Healthcare Technologies Society, New Delhi, Delhi, India
- Department of Nutrition, St. Ann’s College for Women, Hyderabad, India
| | - Manikyarao Ashwitha
- Foundation of Healthcare Technologies Society, New Delhi, Delhi, India
- Department of Nutrition, St. Ann’s College for Women, Hyderabad, India
| | - Jenifer Joanna
- Foundation of Healthcare Technologies Society, New Delhi, Delhi, India
- Department of Nutrition, St. Ann’s College for Women, Hyderabad, India
| | - Srinitya Reddy
- Foundation of Healthcare Technologies Society, New Delhi, Delhi, India
- Department of Nutrition, St. Ann’s College for Women, Hyderabad, India
| | - Batul Idris
- Foundation of Healthcare Technologies Society, New Delhi, Delhi, India
- Department of Nutrition, St. Ann’s College for Women, Hyderabad, India
| | - Persis Myrtle
- Foundation of Healthcare Technologies Society, New Delhi, Delhi, India
- Department of Nutrition, St. Ann’s College for Women, Hyderabad, India
| | - Sarvani Kandamuru
- Foundation of Healthcare Technologies Society, New Delhi, Delhi, India
- Department of Nutrition, St. Ann’s College for Women, Hyderabad, India
| | - Sara Fatima
- Foundation of Healthcare Technologies Society, New Delhi, Delhi, India
- Department of Nutrition, St. Ann’s College for Women, Hyderabad, India
| | - Ashish Joshi
- CUNY Graduate School of Public Health and Health Policy, City University of New York, New York, NY, USA
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Alessa T, Hawley M, de Witte L. Identification of the Most Suitable App to Support the Self-Management of Hypertension: Systematic Selection Approach and Qualitative Study. JMIR Mhealth Uhealth 2021; 9:e29207. [PMID: 34787586 PMCID: PMC8663499 DOI: 10.2196/29207] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/29/2021] [Revised: 04/23/2021] [Accepted: 08/01/2021] [Indexed: 12/11/2022] Open
Abstract
BACKGROUND Smartphone apps are increasingly being used to aid in hypertension self-management, and a large and ever-growing number of self-management apps have been commercially released. However, very few of these are potentially effective and secure, and researchers have yet to establish the suitability of specific hypertension apps to particular contexts. OBJECTIVE The aim of this study is to identify the most suitable hypertension app in the context of Saudi Arabia and its health system. METHODS This study used a 2-stage approach to selecting the most suitable app for hypertension self-management. First, a systematic selection approach was followed to identify a shortlist of the most suitable apps according to the criteria of potential effectiveness, theoretical underpinning, and privacy and security. Second, an exploratory qualitative study was conducted to select the most suitable from the shortlist: 12 doctors were interviewed, and 22 patients participated in 4 focus groups. These explored participants' attitudes towards self-management apps in general, and their views towards the apps identified via the systematic selection process. The qualitative data were analyzed using framework analysis. RESULTS In the first stage, only 5 apps were found to be potentially effective while also having a theoretical underpinning and protecting users' data. In the second stage, both doctors and patients were generally interested in using hypertension apps, but most had no experience with these apps due to a lack of awareness of their availability and suitability. Patients and doctors liked apps that combine intuitive interfaces with a pleasant and clear visual design, in-depth features (eg, color-coded feedback accompanied with textual explanations), activity-specific reminders, and educational content regarding hypertension and potential complications. When the pros and cons of the 5 apps were discussed, 3 apps were identified as being more suitable, with Cora Health rated the highest by the participants. CONCLUSIONS Only 5 apps were deemed potentially effective and secure. Patients' and doctors' discussions of the pros and cons of these 5 apps revealed that 3 out of the 5 are clearly more suitable, with the Cora Health app being judged most suitable overall.
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Affiliation(s)
- Tourkiah Alessa
- Biomedical Technology Department, College of Applied Medical Sciences, King Saud University, Riyadh, Saudi Arabia.,Centre for Assistive Technology and Connected Healthcare, School of Health and Related Research, University of Sheffield, Sheffield, United Kingdom
| | - Mark Hawley
- Centre for Assistive Technology and Connected Healthcare, School of Health and Related Research, University of Sheffield, Sheffield, United Kingdom
| | - Luc de Witte
- Centre for Assistive Technology and Connected Healthcare, School of Health and Related Research, University of Sheffield, Sheffield, United Kingdom
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Tsioufis K, Kreutz R, Sykara G, van Vugt J, Hassan T. Impact of single-pill combination therapy on adherence, blood pressure control, and clinical outcomes: a rapid evidence assessment of recent literature. J Hypertens 2021; 38:1016-1028. [PMID: 32371789 PMCID: PMC7253190 DOI: 10.1097/hjh.0000000000002381] [Citation(s) in RCA: 30] [Impact Index Per Article: 10.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/09/2023]
Abstract
The 2018 European Society of Cardiology/European Society of Hypertension Guidelines for the management of arterial hypertension raised the need for evidence to support the use of single-pill combination (SPC) therapy in preference to free-dosed therapy for hypertension. This systematic rapid evidence assessment sought to determine if initiating SPC therapy improves adherence, blood pressure (BP) control and/or cardiovascular outcomes vs. initiation of free-dose combination therapy.
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Affiliation(s)
- Konstantinos Tsioufis
- First Cardiology Clinic, Medical School, National and Kapodistrian University of Athens, Hippokration Hospital, Athens, Greece
| | - Reinhold Kreutz
- Charité-Universitätsmedizin Berlin, Corporate Member of Freie Universität Berlin, Humboldt-Universität zu Berlin, and Berlin Institute of Health, Institut für Klinische Pharmakologie und Toxikologie, Berlin, Germany
| | - Georgia Sykara
- Medical Affairs, Pfizer Upjohn Hellas Ltd, Athens, Greece
| | - Joris van Vugt
- Medical Affairs, Pfizer Upjohn, Cappelle a/d Ijssel, The Netherlands
| | - Tarek Hassan
- Medical Affairs, Pfizer Upjohn, New York, New York, USA
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Yamamoto K, Takahashi T, Urasaki M, Nagayasu Y, Shimamoto T, Tateyama Y, Matsuzaki K, Kobayashi D, Kubo S, Mito S, Abe T, Matsuura H, Iwami T. Health Observation App for COVID-19 Symptom Tracking Integrated With Personal Health Records: Proof of Concept and Practical Use Study. JMIR Mhealth Uhealth 2020; 8:e19902. [PMID: 32568728 PMCID: PMC7340163 DOI: 10.2196/19902] [Citation(s) in RCA: 29] [Impact Index Per Article: 7.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/14/2020] [Revised: 06/20/2020] [Accepted: 06/21/2020] [Indexed: 01/19/2023] Open
Abstract
BACKGROUND As a counter-cluster measure to prevent the spread of the infectious novel coronavirus disease (COVID-19), an efficient system for health observation outside the hospital is urgently required. Personal health records (PHRs) are suitable for the daily management of physical conditions. Importantly, there are no major differences between the items collected by daily health observation via PHR and the observation of items related to COVID-19. Until now, observations related to COVID-19 have been performed exclusively based on disease-specific items. Therefore, we hypothesize that PHRs would be suitable as a symptom-tracking tool for COVID-19. To this end, we integrated health observation items specific to COVID-19 with an existing PHR-based app. OBJECTIVE This study is conducted as a proof-of-concept study in a real-world setting to develop a PHR-based COVID-19 symptom-tracking app and to demonstrate the practical use of health observations for COVID-19 using a smartphone or tablet app integrated with PHRs. METHODS We applied the PHR-based health observation app within an active epidemiological investigation conducted by Wakayama City Public Health Center. At the public health center, a list is made of individuals who have been in close contact with known infected cases (health observers). Email addresses are used by the app when a health observer sends data to the public health center. Each health observer downloads the app and installs it on their smartphone. Self-observed health data are entered daily into the app. These data are then sent via the app by email at a designated time. Localized epidemiological officers can visualize the collected data using a spreadsheet macro and, thus, monitor the health condition of all health observers. RESULTS We used the app as part of an active epidemiological investigation executed at a public health center. During the investigation, 72 close contacts were discovered. Among them, 57 had adopted the use of the health observation app. Before the introduction of the app, all health observers would have been interviewed by telephone, a slow process that took four epidemiological officers more than 2 hours. After the introduction of the app, a single epidemiological officer can carry out health observations. The app was distributed for free beginning in early March, and by mid-May, it had been used by more than 20,280 users and 400 facilities and organizations across Japan. Currently, health observation of COVID-19 is socially recognized and has become one of the requirements for resuming social activities. CONCLUSIONS Health observation by PHRs for the purpose of improving health management can also be effectively applied as a measure against large-scale infectious diseases. Individual habits of improving awareness of personal health and the use of PHRs for daily health management are powerful armaments against the rapid spread of infectious diseases. Ultimately, similar actions may help to prevent the spread of COVID-19.
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Affiliation(s)
- Keiichi Yamamoto
- Information Technology Center, Wakayama Medical University, Wakayama, Japan
| | | | - Miwa Urasaki
- Wakayama City Public Health Center, Wakayama City, Japan
| | | | | | | | | | | | - Satoshi Kubo
- Suzuka University of Medical Science, Mie, Japan
| | | | | | | | - Taku Iwami
- Kyoto University Health Service, Kyoto, Japan
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