Background: An assessment of the level of adherence of patients diagnosed with hypertension to therapy has not been conducted in Central Asia yet. It includes the lack the information on the impact of digital technologies on hypertension management. Objective: The study aimed at the evaluation of the effect of using a mobile application on adherence to therapy in patients with diagnosed arterial hypertension. Methods: A multi-centre randomized controlled study was conducted on 517 patients with diagnosed arterial hypertension (in the out-patient clinic, Almaty, Kazakhstan). Patients were randomly assigned to intervention (IG) and control (CG) groups. IG patients used a mobile application, which allowed creating an individual schedule for taking medications, including visual and audio notifications. The assessment of adherence to antihypertensive treatment was carried out using the Lebanese Medication Adherence Scale-14 (LMAS-14), consisting of 14 items. Data were collected before therapy (T1), 3 months (T2), 6 months (T3) and 12 months (T4) followed the first dose. Adherence was assessed on 101 patients in the CG group and 165 respondents in the IG group. Results: In the period T1 in both groups CG and IG, a moderate adherence to treatment was recorded with indices equal to 35.9 ± 1.2 and 35.9 ± 1.3, respectively (p ≤ 0.05). A decrease in adherence in the CG group was determined after 3 months (35.9 ± 1.2) (p ≤ 0.05) and six months later (36.5 ± 3.2) in comparison with relatively high adherence among respondents in the IG group in periods T2 (39.5 ± 1.2) and T3 (40.5 ± 1.2) (p ≤ 0.001). After 12 months (T4) on the adherence scale in patients who used the mobile application “MyTherapy” (IG), despite a slight decrease in scores, the results were relatively higher (40.3 ± 1.3) compared with the CG group (33.6 ± 1.9) (p ≤ 0.001). Conclusion: The analysis of adherence of patients with primary health care in Almaty (Kazakhstan) with chronic arterial hypertension showed the effectiveness of using the ‘MyTherapy’ mobile application in increasing patient adherence. The obtained data on the positive effect of the use of digital technologies require further research to assess the possibility of wider implementation in healthcare.
Background: Chronic obstructive pulmonary disease (COPD) is a global public health problem, and continuous monitoring is essential for both its management as well as the management of other chronic diseases. Telemonitoring using mobile health (mHealth) devices has the potential to promote self-management, improve control, increase quality of life, and prevent hospital admissions. Objective: This proof-of-concept study aims to assess feasibility, accuracy, and reproducibility of biosensing (mHealth) devices in monitoring of heart rate, physical activity and respiratory function in smokers with and without respiratory symptoms and COPD. Methods: A total of 3 cohorts, with 9 participants in each, used mHealth devices for 90 days while undergoing the current standard of care. These groups were: 9 “non-COPD,” otherwise healthy, smokers; 9 “grey zone” smokers (forced expiratory volume in 1 second/ forced vital capacity ?0.70 after bronchodilator treatment; COPD Assessment Test ?10); and 9 smokers diagnosed with Stage 1-3 COPD. Two mHealth devices were utilized in the study: (1) the AnaMed Original Equipment Manufacturer device (OEM) that measures distance, energy expenditure, heart rate, and heart rate variability by using photoplethysmographic method and displays the results on a watchface, smartphone or a tablet, and (2) the Air Next mobile spirometry portable device that performs spirometric measurements (FEV1, FVC and FEV1/FVC ratio) by a turbine mechanism and displays the results on a smartphone or a tablet. The mHealth devices were compared against industry standards. Recruitment, retention and adherence rates were 35%, 100%, and 63% respectively. Additionally, a questionnaire was administered to assess the participants’ perceptions of the mHealth technologies used. Results: The AnaMed device was demonstrated as precise in measuring heart rate, and less so when measuring number of steps and meters. It is unreliable in measuring SpO2. It is easy to use, requires no significant technical support. The Air-Next Spirometer is a simple and very precise instrument for detecting obstructive airway diseases which was confirmed when compared to the industry standard. It is easy to use, which could make it especially useful for non-specialized care and in-home setting and other areas. Conclusion: We demonstrated that both devices, AnaMed and AirNext can provide precise measurements or heart rate and spirometric data, and it is feasible to incorporate them into a routine clinical practice for remote monitoring of chronic conditions such as COPD. However, such task would require some efforts to take care of technical and logistical issues, i.e. sending reminders, synching devices with smartphones, communication efforts.
BACKGROUND Chronic obstructive pulmonary disease (COPD) is a global public health problem, and continuous monitoring is essential for both its management as well as the management of other chronic diseases. Telemonitoring using mobile health (mHealth) devices has the potential to promote self-management, improve control, increase quality of life, and prevent hospital admissions. OBJECTIVE This feasibility and proof-of-concept study aims to assess utility (sensitivity, accuracy, and reproducibility) of biosensing (mHealth) devices in monitoring of physical activity and respiratory function in smokers with and without respiratory symptoms/COPD. METHODS A total of 3 cohorts, with 9 participants in each, used mHealth devices for 90 days while undergoing the current standard of care. These groups were: 9 “non-COPD,” otherwise healthy, smokers; 9 “grey zone” smokers (forced expiratory volume in 1 second/ forced vital capacity ≥0.70 after bronchodilator treatment; COPD Assessment Test ≥10); and 9 smokers diagnosed with Stage 1-3 COPD. Rates of recruitment, retention, and adherence will be measured. Overall, two mHealth devices were utilized in the study: (1) the AnaMed Original Equipment Manufacturer device (OEM) that measures distance, energy expenditure, heart rate, and heart rate variability by using photoplethysmographic method and displays the results on a watchface, smartphone or a tablet, and (2) the Air Next mobile spirometry device portable device that performs spirometric measurements (FEV1, FVC and FEV1/FVC) ratio by a turbine mechanism and displays the results on a smartphone or a tablet. The mHealth devices were compared against industry standards. Additionally, a questionnaire will be administered to assess the participants’ perceptions of the mHealth technologies used. RESULTS The AnaMed device was demonstrated as precise in measuring heart rate, and less so when measuring number of steps and meters. It is unreliable in measuring SpO2. It is easy to use, requires no significant technical support. The Air-Next Spirometer is a simple and very precise instrument for detecting obstructive airway diseases which was confirmed when compared with the industry standard. It is easy to use, which could make it especially useful non-specialized care and in-home setting and other areas. CONCLUSIONS We demonstrated that both devices, AnaMed and AirNext can provide precise measurements or heart rate and spirometric data, and it is feasible to incorporate them into a large-scale study. However, such task would require serious efforts to hire technical staff and to provide additional training for the clinical investigators to take care of technical and logistical issues, i.e. sending reminders, synching devices with smartphones, communication efforts. CLINICALTRIAL ClinicalTrials.gov NCT04081961; https://clinicaltrials.gov/ct2/show/NCT04081961
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