Digital Management of Hypertension Improves Systolic Blood Pressure Variability

Milani, Richard V.; Wilt, Jonathan K.; Milani, Alexander R.; Bober, Robert; Malamud, Eric; Entwisle, Jonathan; Lavie, Carl J.

doi:10.1016/j.amjmed.2019.10.043

Cited by 6 publications

(8 citation statements)

References 21 publications

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“…It should be also noted that some studies have been mainly focussed on the assessment of the effectiveness of telemedicine and remote interaction for monitoring the conditions of patients with arterial hypertension (29) . So there is still a need for further research to determine the effect of innovative technologies on clinical outcomes (30) .…”

Section: Introductionmentioning

confidence: 99%

Evaluation of the Effectiveness of the Mobile Application on Adherence of Patients With Arterial Hypertension

Nurakysh¹,

Kurakbayev²,

Кошербаева³

et al. 2022

Acta Inform Med

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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.

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Section: Introductionmentioning

confidence: 99%

Evaluation of the Effectiveness of the Mobile Application on Adherence of Patients With Arterial Hypertension

Nurakysh¹,

Kurakbayev²,

Кошербаева³

et al. 2022

Acta Inform Med

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“…52 They achieved greater BP control and lower systolic BP variability, with higher levels of satisfaction at 6 months. 31,53,54 Task shifting within these care teams resulted in a 29% reduction of primary care provider clinic visits for hypertension over the same period. 53…”

Section: Tracking and Reporting Outcomesmentioning

confidence: 99%

Innovative Remote Management Solutions for the Control of Hypertension

Lee

Fisher

2023

Hypertension

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We stand at a critical juncture in the delivery of health care for hypertension. Blood pressure control rates have stagnated, and traditional health care is failing. Fortunately, hypertension is exceptionally well-suited to remote management, and innovative digital solutions are proliferating. Early strategies arose with the spread of digital medicine, long before the COVID-19 pandemic forced lasting changes to the way medicine is practiced. Highlighting one contemporary example, this review explores salient features of remote management hypertensive programs, including: an automated algorithm to guide clinical decisions, home (as opposed to office) blood pressure measurements, an interdisciplinary care team, and robust information technology and analytics. Dozens of emerging hypertension management solutions are contributing to a highly fragmented and competitive landscape. Beyond viability, profit and scalability are critical. We explore the challenges impeding large-scale acceptance of these programs and conclude with a hopeful look to the future when remote hypertension care will have dramatic impact on global cardiovascular health.

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“…Patients with uncontrolled HTN on average have four BPs documented in the medical record per year and fewer recorded values are noted in those with controlled BP [17]. Compared to the relatively small sample of in-office BP values, the higher sampling frequency afforded by home monitoring has been shown to improve the likelihood of BP control and is more likely to detect natural variabilities in BP that would otherwise be missed by in-office values [18,19 ▪ ]. Capturing and reducing BP variability is an important component in BP management as several studies have now demonstrated that systolic BP variability better predicts all-cause and CVD, mortality, stroke, and total CVD, compared to average systolic BP [14,20].…”

Section: Home-measured Bpmentioning

confidence: 99%

New aspects in the management of hypertension in the digital era

Milani

Lavie

Ventura

2021

Current Opinion in Cardiology

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Purpose of reviewHypertension (HTN) is the most common chronic disease impacting over half the US adult population. Our current office-based model of care is failing in its ability to control blood pressure (BP) as only 44% of adult US hypertensives are achieving minimal levels of BP control (< 140/90 mmHg), leading to high rates of preventable cardiovascular events and death. Recent findingsReengineering care delivery using a fully digital platform combined with a dedicated team-based approach to HTN management has demonstrated superior BP control rates, very high levels patient acceptance, and the ability to better diagnose and treat masked and white coat HTN.

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Digital Management of Hypertension Improves Systolic Blood Pressure Variability

Cited by 6 publications

References 21 publications

Evaluation of the Effectiveness of the Mobile Application on Adherence of Patients With Arterial Hypertension

Evaluation of the Effectiveness of the Mobile Application on Adherence of Patients With Arterial Hypertension

Innovative Remote Management Solutions for the Control of Hypertension

New aspects in the management of hypertension in the digital era

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