scholarly journals iMedA: improving medication adherence through adaptive digital interventions in patients with hypertension: Protocol for an Interrupted time-series study (Preprint)

2020 ◽  
Author(s):  
Kobra Etminani ◽  
Carina Göransson ◽  
Alexander Galozy ◽  
Margaretha Norell Pejner ◽  
Sławomir Nowaczyk
Keyword(s):  
Blood Pressure ◽  
Medication Adherence ◽  
Care Management ◽  
Self Care ◽  
Interrupted Time Series ◽  
Mobile App ◽  
Improve Medication Adherence ◽  
Hypertensive Patients ◽  
Digital Interventions ◽  
Digital Intervention

BACKGROUND There is a strong need to improve medication adherence (MA) for hypertensive patients in order to reduce long-term hospitalization costs. We believe this can be achieved through an AI agent that helps the patient in understanding key individual adherence risk factors and designing an appropriate intervention plan. The incidence of hypertension in Sweden is estimated at approximately 27%. Among American adults diagnosed with hypertension only 54% had their condition under control; another 32% had prehypertension-level blood pressure. The direct and indirect healthcare costs due to uncontrolled hypertension in the US alone are estimated at 49 billion dollars each year. It is a major risk factor for coronary heart disease and stroke as well as heart failure. MA is a key factor for good clinical outcomes in hypertensive patients. OBJECTIVE The overall aim of this study is to design, develop, test, and evaluate an adaptive digital intervention called iMedA, delivered via a mobile app to improve MA and self-care management, and in longer-term blood pressure control, for persons with hypertension. METHODS The study design is considered to be an interrupted time series (ITS). We will collect data on a daily basis, 14 days before, during 6 months of delivering digital interventions through the mobile app, and after that. The effect will be analyzed using segmented regression analysis. The participants will be recruited in Region Halland, Sweden. The design of the digital interventions follows the Just-In-Time Adaptive Intervention (JITAI) framework. The primary (distal) outcome is MA, and the secondary outcome is blood pressure. The design of the digital intervention is developed based on a need assessment process including a systematic review, focus group interviews, and a pilot study, before going for the longitudinal ITS study. RESULTS The focus groups of persons with hypertension have been conducted to perform the need assessment. The design and development of digital interventions is under progress and is planned to be ready in September 2020. Then the 2-week pilot study for usability evaluation will get started, and then the ITS study will follow it, which we plan to start in October 2020. CONCLUSIONS We hypothesize that iMedA will improve medication adherence and self-care management. This study could illustrate how self-care management tools can be an additional (digital) treatment support to a clinical one without increasing burden on healthcare staff. CLINICALTRIAL ClinicalTrials.gov NCT04413500; https://clinicaltrials.gov/ct2/show/NCT04413500medication adherence; hypertension; digital intervention; mHealth; Artificial Intelligence

PERAN KELUARGA DALAM MEMANTAU KEPATUHAN MINUM OBAT PENDERITA HIPERTENSI PADA MASYARAKAT

2017 ◽  
Vol 3 (1) ◽  
Author(s):  
Saiful Nurhidayat
Keyword(s):  
Blood Pressure ◽  
Medication Adherence ◽  
Rural Communities ◽  
Elementary Education ◽  
College Education ◽  
Cross Sectional ◽  
Hypertensive Patients ◽  
Purposive Sampling ◽  
The Family

Abstract : Hypertension or high blood pressure is an abnormal increase in blood pressure in the arteries continuously over a period. The dangers of hypertension can lead to damage to various organs including kidneys, brain, heart, eye, causing vascular resistance and stroke. Hypertension takes care of the old and continuously. One effective way to lower blood pressure is to obediently take medicine so that it takes the role of families in monitoring patients taking the medication. With the participation of the family are expected to hypertension sufferers can be controlled. This study aims to determine the family's role in monitoring the adherence of hypertensive patients. The study was conducted in rural communities Slahung Ponorogo, a representative sample of 53 respondents taken by purposive sampling. Quantitative design with cross sectional design of the study the family's role in monitoring the adherence of hypertensive patients. Instruments in this study using questionnaires and observation sheets. The results of 53 respondents obtained the majority of the 29 respondents (55%) has the role of both families and 24 respondents (45%) families have a bad role in monitoring medication adherence. Age and education contribute to determining the role family. Intermediate (41-60 years old) and college education contribute to determining the role well. Conversely > 61 years of elementary education and contribute in a bad role.Keywords : the role of the family, medication adherence, hypertension. Abstrak : Hipertensi atau tekanan darah tinggi adalah suatu peningkatan abnormal tekanan darah dalam pembuluh darah arteri secara terus-menerus lebih dari suatu periode. Bahaya hipertensi dapat memicu rusaknya berbagai organ tubuh diantaranya: ginjal, otak, jantung, mata, menyebabkan resistensi pembuluh darah dan stroke. Penyakit hipertensi membutuhkan perawatan yang lama dan terus menerus. Salah satu cara yang efektif untuk menurunkan tekanan darah adalah dengan patuh minum obat sehingga dibutuhkan peran keluarga dalam memantau minum obat penderita. Dengan adanya peran serta keluarga diharapkan penyakit hipertensi penderita dapat terkontrol. Penelitian ini bertujuan untuk mengetahui peran keluarga dalam memantau kepatuhan minum obat penderita hipertensi. Penelitian dilakukan pada masyarakat desa Slahung Ponorogo,sampel representatif sejumlah 53 responden diambil secara Purposive Sampling. Desain kuantitatif dengan rancangan Cross sectional yang mempelajari peran keluarga dalam memantau kepatuhan minum obat penderita hipertensi. Instrumen pada penelitian ini menggunakan kuesioner dan lembar observasi. Hasil penelitian dari 53 responden didapatkan sebagian besar 29 responden (55 %) keluarga mempunyai peran baik dan 24 responden (45 %) keluarga mempunyai peran buruk dalam memantau kepatuhan minum obat. Faktor usia dan pendidikan berkontribusi dalam menentukan peran keluarga. Usia madya (41-60 tahun) dan jenjang pendidikan perguruan tinggi berkontribusi dalam menentukan peran baik. Sebaliknya > 61 tahun dan jenjang pendidikan SD berkontribusi dalam peran buruk.Kata Kunci : peran keluarga, kepatuhan minum obat, penyakit hipertensi.

scholarly journals Acceptability and feasibility of a mobile health application for blood pressure monitoring in rural Uganda

JAMIA Open ◽  
2021 ◽  
Author(s):  
Beatrice Mugabirwe ◽  
Tabor Flickinger ◽  
Lauren Cox ◽  
Pius Ariho ◽  
Rebecca Dillingham ◽  
...  
Keyword(s):  
Social Support ◽  
Blood Pressure ◽  
Medication Adherence ◽  
Blood Pressure Control ◽  
Pressure Control ◽  
Mobile App ◽  
People Living With Hiv ◽  
Resource Limited Settings ◽  
Self Monitoring ◽  
Resource Limited

Abstract Background Mobile technologies to improve blood pressure control in resource-limited settings are needed. We adapted and evaluated the acceptability and feasibility of PositiveLinks, a mobile phone application for self-monitoring, social support, and engagement in care for people living with HIV, among patients with hypertension in rural Uganda. Methods We enrolled adults on treatment for hypertension at Mbarara Regional Referral Hospital and Mbarara Municipal health center IV, southwestern Uganda. We provided and educated all participants on the use of PositiveLinks application and automated blood pressure monitors. We administered a baseline questionnaire and performed in-depth interviews 30 days later to explore acceptability, feasibility, medication adherence, social support, and blood pressure control. Results A total of 37 participants completed the interviews, mean age of 58 years (SD 10.8) and 28 (75.7%) were female. All participants embraced the PositiveLinks mobile app and were enthusiastic about self-monitoring of blood pressure, 35 (94.6%) experienced peer to peer support. Among the 35 participants non-adherent to medications at baseline, 31 had improved medication adherence. All except 1 of the 31(83.8%) who had uncontrolled blood pressure at baseline, had self-reported controlled blood pressure after 30 days of use of PositiveLinks. Conclusion Patients with hypertension in rural Uganda embraced the PositiveLinks mobile application and had improved medication adherence, social support, and blood pressure control. Further assessment of cost-effectiveness of the application in blood pressure control in resource-limited settings will be pursued in future studies.

scholarly journals SaO014USE OF A MOBILE APP TO IMPROVE MEDICATION ADHERENCE IN KIDNEY TRANSPLANT RECIPIENTS - A PROSPECTIVE INTERVENTIONAL STUDY

2018 ◽  
Vol 33 (suppl_1) ◽  
pp. i321-i321 ◽  
Author(s):  
Oliver Staeck ◽  
Sebastian Georgi ◽  
Dmytro Khadzhynov ◽  
Lukas Lehner ◽  
Eva Schrezenmeier ◽  
...  
Keyword(s):  
Medication Adherence ◽  
Kidney Transplant ◽  
Mobile App ◽  
Transplant Recipients ◽  
Kidney Transplant Recipients ◽  
Interventional Study ◽  
Improve Medication Adherence

Mobile App Interventions to Improve Medication Adherence Among Type 2 Diabetes Mellitus Patients: A Systematic Review of Clinical Trials

2021 ◽  
pp. 193229682110600
Author(s):  
Tarani Prakash Shrivastava ◽  
Shikha Goswami ◽  
Rahul Gupta ◽  
Ramesh K. Goyal
Keyword(s):  
Diabetes Mellitus ◽  
Type 2 Diabetes ◽  
Clinical Trials ◽  
Type 2 Diabetes Mellitus ◽  
Medication Adherence ◽  
Mobile Apps ◽  
Mobile App ◽  
Risk Of Bias ◽  
Improve Medication Adherence

Background: Medication adherence in type 2 diabetes mellitus (T2DM) patients is often suboptimal resulting in complications. There has been a growing interest in using mobile apps for improving medication adherence. Objective: The objective of this work was to systematically review the clinical trials that have used mobile app–based interventions in T2DM patients for improving medication adherence. Methodology: A systematic search was performed to identify published clinical trials between January 2008 and December 2020 in databases—PubMed, Cochrane Library, and Google Scholar. All studies were assessed for risk of bias using quality rating tool from the Cochrane Handbook for Systematic Reviews of Interventions. Results: Seven clinical studies having 649 participants were studied. The median sample size was 58 (range = 41-247) and the median age of participants was 53.2 (range = 48-69.4) years. All studies showed improvements in adherence; however, only three studies reported statically significant improvements in adherence measures. Selected studies were deemed as unclear in their risk of bias and the most common source of risk of bias among the studies was the absence of objective outcome assessment. Conclusions: Mobile apps appear to be effective interventions to help improve medication adherence in T2DM patients compared with conventional care strategies. The features of the App to improvise medical adherence cannot be defined based on the meta-analysis because of heterogeneity of study designs and less number of sample size. Systematically planned studies would set up applicability of mobile apps in the clinical management of T2DM.

High blood pressure self-care among hypertensive patients in Iran: a theory-driven study

2020 ◽  
Author(s):  
Iraj Zareban ◽  
Marzieh Araban ◽  
Mohammad Reza Rohani ◽  
Mahmood Karimy ◽  
Fereshteh Zamani-Alavijeh ◽  
...  
Keyword(s):  
Blood Pressure ◽  
High Blood Pressure ◽  
Self Care ◽  
Hypertensive Patients

scholarly journals Determinants of adherence to anti-hypertensive medications among adult hypertensive patients on follow-up in Hawassa Referral Hospital: A case–control study

2019 ◽  
Vol 8 ◽  
pp. 204800401989275
Author(s):  
Atsede Getenet ◽  
Mulugeta Tesfa ◽  
Aster Ferede ◽  
Yalew Molla
Keyword(s):  
Blood Pressure ◽  
Logistic Regression ◽  
Medication Adherence ◽  
Case Control Study ◽  
Case Control ◽  
Referral Hospital ◽  
Hypertensive Patients ◽  
Adherence Scale ◽  
Control Study

Introduction Hypertension is a global challenge which accounts for high morbidity and mortality rates in the world. The availability of effective anti-hypertensive medications does not result in a good outcome in controlling blood pressure which points towards poor adherence. Thus, this study was conducted to assess the determinants of adherence to anti-hypertensive medication among hypertensive patients on follow-up in Hawassa Referral Hospital. Methods Institution-based case–control study was conducted on a sample of 289 clients from February to May 2018. Census was conducted on 1600 clients to select cases and controls. Then, systematic random sampling was used to select study subjects, and adherence was measured by Morisky medication adherence scale. The associations of variables were analyzed using bivariable followed by multivariable logistic regression analyses. Results The respondent’s adherence to medication was found to be 67% as measured by Morisky medication adherence scale. The multivariate logistic regression analysis showed that medication adherence was found to be better in younger age (<45) (AOR = 3.8), clients living in urban areas (AOR = 6.84), those clients who had good knowledge (AOR = 3.13), those with no co-morbidities (AOR = 3.14) and patients who controlled their blood pressure (<140/90) (AOR = 2.35). Conclusions The rate of medication adherence was found to be low, and hence educational interventions focusing on factors promoting adherence and patients’ health support should be implemented.

scholarly journals Effects of Emotional Response on Adherence to Antihypertensive Medication and Blood Pressure Improvement

2013 ◽  
Vol 2013 ◽  
pp. 1-8 ◽  
Author(s):  
Robert D. Keeley ◽  
Margaret Driscoll
Keyword(s):  
Blood Pressure ◽  
Medication Adherence ◽  
Emotional Response ◽  
Antihypertensive Medication ◽  
Primary Outcome ◽  
Secondary Outcome ◽  
Behavioral Risk ◽  
Improve Medication Adherence ◽  
Pharmacy Refill ◽  
Adherence Score

Background. Developing interventions to improve medication adherence may depend upon discovery of novel behavioral risk factors for nonadherence.Objective. Explore the effects of emotional response (ER) on adherence to antihypertensive medication and on systolic blood pressure (SBP) improvement.Design. We studied 101 adults with diabetes and hypertension. The primary outcome, 90-day “percentage of days covered” adherence score, was determined from pharmacy refill records. The secondary outcome was change in SBP over 90 days. ER was classified as positive, negative, or neutral.Results. Average adherence was 71.6% (SD 31.4%), and negative and positive ER were endorsed by 25% and 9% of subjects, respectively. Gender moderated the effect of positive or negative versus neutral ER on adherence (interactionP=0.003); regardless of gender, negative and positive ER were associated with similarly high and low adherence, respectively, but males endorsing neutral ER had significantly higher adherence than their female counterparts (85.6% versus 57.1%,Fvalue = 15.3,P=0.0002). Adherence mediated ER's effect on SBP improvement: among participants with negative, but not positive or neutral, ER, increasing adherence and SBP improvement were correlated (Spearman’sr=0.49,P=0.02).Conclusions. Negative, but not positive or neutral, ER predicted better medication adherence and a correlation between medication adherence and improvement in SBP.

Sign in / Sign up

Export Citation Format

Share Document