Pilot Study of Applying Self-Monitoring Smartphone Based Application for Management of Hypertension

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Abstract Summary
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Authors (including presenting author) :
LO KM (1), Chan TF (2), Ng ML (2), Zhang M (3), Ho CM (4), Ho P (5), Wong WY (2), YIU CH (2), Lau ST (1)
Affiliation :
(1) Department of Medicine and Geriatrics, OLMH (2) Out-patient Department, OLMH (3) Lee Kong Chian School of Medicine, Nanyang Technological University (4) Department of Psychological Medicine, National University of Singapore (5) Department of Surgery, National University of Singapore
Introduction :
Optimal blood pressure (BP) control was proven to reduce the development of complications of hypertension including stroke, heart failure and renal failure. A large percentage of hypertensive patients have suboptimal BP control. Modern smartphone technology has revolutionized health data collection and transfer.
Objectives :
A pilot study is conducted to assess the feasibility, adoption and patients' satisfaction of using a smartphone-based application to promote self-BP monitoring.
Methodology :
Patients aged 18 or older with hypertension were recruited. Patients recruited should have smartphones and be able to handle simple smartphone applications by themselves or by their caregivers. They should also have electronic home BP measuring device. Upon consent to participate, patients were asked to download the study app, which was developed by the National University of Singapore, into their personal smartphones. The app included hypertension health information, reminder of BP checking, BP data record and chart generation. Patients or their caregivers were trained to use the app. At a pre-set frequency (time and day of a week), patients would be prompted to check BP and record the readings into the app. If the BP readings were beyond pre-set threshold values, the app would automatically prompt the patient to recheck or contact the clinic for earlier follow-up. The participating patients would feedback about the app 4 to 6 months later.
Result & Outcome :
23 patients, aged 70 to 88, were recruited. 19 patients were female. 1 patient defaulted follow up. Among 22 patients, 18 patients (81.8%) had no prior experience in using smartphone apps to record their home BP readings. Before the study, 10 patients (45.5%) never or only measured their BP when feeling sick. After the study, 21 patients (95.5%) reported that they would measure their home BP at interval. 16 patients (72.7%) found the app useful or very useful to allow the doctor to understand their BP trend during follow up. 6 patients (27.3%) were found to have suboptimally controlled BP and 2 patients (9.1%) were found to have lowish BP while they were using the app and had their antihypertensive medications adjusted. Smartphone-based app is well accepted and the technology can be applied to elderly patients with the help of their caregivers. The smartphone app successfully motivated a high percentage (95.5%) of studied patients to check their home BP. 72.2% patients found the app useful for doctors to understand their BP control during clinic visits. Antihypertensive medications were being adjusted in 36.4% of patients while they were using the app, suggesting the app might have facilitated the doctor to manage patients’ hypertension in a more effective manner.

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