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PurposeA wealth of mobile applications are designed to support users in their drug intake. When developing software for patients, it is important to understand the differences between individuals who have, who will or who might never adopt mobile interventions. This study analyzes demographic and health-related factors associated with real-life “longer usage” and the “usage-intensity per day” of the mobile application “Medication Plan”.MethodsBetween 2010-2012, the mobile application “Medication Plan” could be downloaded free of charge from the Apple-App-Store. It was aimed at supporting the regular and correct intake of medication. Demographic and health-related data were collected via an online questionnaire. This study analyzed captured data.ResultsApp-related activities of 1799 users (1708 complete data sets) were recorded. 69% (1183/1708) applied “Medication Plan” for more than a day. 74% were male (872/1183), the median age 45 years. Variance analysis showed a significant effect of the users´ age with respect to duration of usage (p = 0.025). While the mean duration of use was only 23.3 days for users younger than 21 years, for older users, there was a substantial increase over all age cohorts up to users of 60 years and above (103.9 days). Sex and educational status had no effect. “Daily usage intensity” was directly associated with an increasing number of prescribed medications and increased from an average of 1.87 uses per day and 1 drug per day to on average 3.71 uses per day for users stating to be taking more than 7 different drugs a day (p<0.001). Demographic predictors (sex, age and educational attainment) did not affect usage intensity.ConclusionUsers aged 60+ as well as those with complicated therapeutic drug regimens relied on the service we provided for more than three months on average. Mobile applications may be a promising approach to support the treatment of patients with chronic conditions.

SOCIAL MARKETING - SEDUCTION WITH THE AIM OF HEALTHY BEHAVIOR? Social marketing is the use of marketing principles to design and implement programs that promote socially beneficial behaviour change. Contrary to the marketing of consumption goods, social marketing does not deal with material products, but with behaviour, e. g. not smoking. This 'product' has a basic benefit (i. e. reduction of health risks in the long run), which is, however, difficult to convey. Therefore, the intended change in behaviour has to be related to a further reward which consists of symbolic goods, e. g. social appreciation or a better body feeling. The communication policy is essential for information on and motivation for the preventive issue. Social marketing campaigns whose development and management follow the principles of classical marketing can render preventive efforts more effective. In addition, social marketing can lead to a better quality management as compared to conventional preventive activities. These advantages can be explained by a) tailoring the campaign more specifically to the target group's needs and motives, b) presenting health risks more convincingly, and c) continuously analysing and evaluating the campaign and its effects. On the other hand, the marketing of preventive aims through mass media can bear several risks, as exemplified by different national and international public health campaigns. The necessity to communicate briefly and succinctly can lead to misleading simplifications and, in case of cancer screening, to the trivialization of a behaviour's consequences and adverse effects. Also, many campaigns do not intend to educate and inform, but try to persuade target persons of a certain behaviour, using emotions such as fear. This has led to social marketing being criticized as manipulation. Sometimes, social marketing campaigns cause stigma and discrimination of certain population subgroups, e. g. obese or HIV-positive people. Health promoters who plan mass media campaigns can be recommended to follow marketing principles in order to improve the campaign's impact. However, they should also consider possible adverse effects of the communication strategy on the social perception of health behavior, health risks and the responsibility of certain subgroups.

In patients with active

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BackgroundEvidence that home telemonitoring for patients with chronic heart failure (CHF) offers clinical benefit over usual care is controversial as is evidence of a health economic advantage.MethodsBetween January 2010 and June 2013, patients with a confirmed diagnosis of CHF were enrolled and randomly assigned to 2 study groups comprising usual care with and without an interactive bi-directional remote monitoring system (Motiva®). The primary endpoint in CardioBBEAT is the Incremental Cost-Effectiveness Ratio (ICER) established by the groups’ difference in total cost and in the combined clinical endpoint “days alive and not in hospital nor inpatient care per potential days in study” within the follow-up of 12 months.ResultsA total of 621 predominantly male patients were enrolled, whereof 302 patients were assigned to the intervention group and 319 to the control group. Ischemic cardiomyopathy was the leading cause of heart failure. Despite randomization, subjects of the control group were more often in NYHA functional class III–IV, and exhibited peripheral edema and renal dysfunction more often. Additionally, the control and intervention groups differed in heart rhythm disorders. No differences existed regarding risk factor profile, comorbidities, echocardiographic parameters, especially left ventricular and diastolic diameter and ejection fraction, as well as functional test results, medication and quality of life. While the observed baseline differences may well be a play of chance, they are of clinical relevance. Therefore, the statistical analysis plan was extended to include adjusted analyses with respect to the baseline imbalances.ConclusionsCardioBBEAT provides prospective outcome data on both, clinical and health economic impact of home telemonitoring in CHF. The study differs by the use of a high evidence level randomized controlled trial (RCT) design along with actual cost data obtained from health insurance companies. Its results are conducive to informed political and economic decision-making with regard to home telemonitoring solutions as an option for health care. Overall, it contributes to developing advanced health economic evaluation instruments to be deployed within the specific context of the German Health Care System.Trial registrationClinicalTrials.gov NCT02293252; date of registration: 10 November 2014

The results suggest that the internet might be helpful in the treatment of borderline patients, especially with regard to the coordination of therapeutical interventions or as an amendment of traditional face-to-face therapies.

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