scholarly journals Effectiveness of mobile phone-based self-management interventions for medication adherence and change in blood pressure in patients with coronary heart disease: A systematic review and meta-analysis

2019 ◽  
Vol 19 (3) ◽  
pp. 192-200 ◽  
Author(s):  
Yun Shan Sua ◽  
Ying Jiang ◽  
David R Thompson ◽  
Wenru Wang
Keyword(s):  
Blood Pressure ◽  
Coronary Heart Disease ◽  
Heart Disease ◽  
Medication Adherence ◽  
Mobile Phone ◽  
Mean Difference ◽  
Self Management ◽  
Medium Size ◽  
Significant Heterogeneity ◽  
Management Interventions

Aims: The aim of this study was to synthesise and evaluate the effectiveness of mobile phone-based self-management interventions for medication adherence and change in blood pressure in patients with coronary heart disease. Methods: Relevant randomised controlled trials evaluating mobile phone-based self-management interventions for medication adherence and/or change in blood pressure in coronary heart disease patients were identified by searching six electronic databases (PubMed, Cochrane, CINAHL, ProQuest, Scopus and EMBASE) from January 2008 to January 2019. The trials were screened, data were extracted and quality was assessed by two independent reviewers. Meta-analyses were performed for different outcomes while narrative syntheses were conducted for studies that could not be pooled or when there was the presence of high heterogeneity. Results: Fifteen trials were included in this review, of which 11 of these trials were meta-analysed. Mobile phone-based self-management interventions were associated with a statistically significant reduction in diastolic blood pressure (combined mean difference of −1.99 (95% confidence interval (CI) –3.20 to −0.78; P=0.0001)). However, the combined effect on medication adherence (medium size effect of d=0.72 (95% CI −0.32 to 1.75; P=0.17)) and change in systolic blood pressure (combined mean difference of −1.08 (95% CI −5.51 to 3.35; P=0.63)) was not statistically significant. There was significant heterogeneity among the trials reviewed. Conclusion: Mobile phone-based self-management interventions have the potential to improve self-management and adherence in patients with coronary heart disease but better designed, conducted and reported trials are needed to demonstrate this.

scholarly journals Perceptions and experiences of using mobile technology for medication adherence among older adults with coronary heart disease: A qualitative study

2020 ◽  
Vol 6 ◽  
pp. 205520762092684
Author(s):  
Linda G Park ◽  
Fion Ng ◽  
Janet K Shim ◽  
Abdelaziz Elnaggar ◽  
Ofelia Villero
Keyword(s):  
Older Adults ◽  
Coronary Heart Disease ◽  
Heart Disease ◽  
Medication Adherence ◽  
Mobile Phone ◽  
Mobile Technology ◽  
Text Messaging ◽  
Future Research ◽  
Antiplatelet Medication ◽  
Mobile Phone Applications

Objective Medication non-adherence is linked to adverse clinical outcomes (i.e. rehospitalization, mortality) among patients with coronary heart disease. Given its global adoption and growing popularity among older adults, mobile technology may be an effective strategy to improve medication adherence. The aim of this article is to present the perceptions, attitudes, and beliefs of individuals with coronary heart disease about using text messaging and mobile phone applications for medication adherence. Methods We recruited 28 participants (veterans and non-veterans) with a history of coronary heart disease and antiplatelet medication use in Northern California. We formed six focus groups of individuals who participated in three sessions (total 18 sessions). We analyzed our data using grounded theory. Results The median age was 69.5 ± 10.8 years for non-veterans (50% male) and 70 ± 8.6 years for veterans (100% male). In the first session, we found that participants perceived text message reminders as a convenient, easy, and flexible tool to establish a routine for taking medications. In the second session, participants were eager to use applications for their greater interactivity, individualized health monitoring, and personalized medication information. The third session, participants shared preferred features (i.e. drug interactions, tracking symptoms) after using two applications at home for 2 weeks. Conclusions Older adults are engaged and can be proficient mobile technology users. Text messaging and mobile phone applications are perceived as helpful tools for medication adherence. Future research should include rigorous clinical trials to test the efficacy of mobile health technology to promote medication adherence in populations that require strict medication adherence.

scholarly journals The Impact of Text Message On Self-Management for Coronary Heart Disease: A Meta-Analysis of Randomized Controlled Trials

2020 ◽  
Vol 23 (1) ◽  
pp. E018-E024
Author(s):  
Yong Wan ◽  
Xin Wu ◽  
Yan Kou
Keyword(s):  
Blood Pressure ◽  
Coronary Heart Disease ◽  
Heart Disease ◽  
Meta Analysis ◽  
Text Message ◽  
Self Management ◽  
Controlled Trials ◽  
Randomized Controlled ◽  
Text Message Intervention ◽  
The Impact

Introduction: The influence of text message on self-management for coronary heart disease remains controversial. We conducted a systematic review and meta-analysis to explore the impact of text message versus usual care on self-management for coronary heart disease. Methods: We searched PubMed, EMbase, Web of Science, EBSCO, and Cochrane library databases through July 2018 for randomized controlled trials (RCTs), assessing the effect of text message versus usual care on self-management for coronary heart disease. This meta-analysis is performed using the random-effect model. Results: Six RCTs involving 1,158 patients are included in the meta-analysis. Overall, compared with a control group for coronary heart disease, text message intervention has no substantial influence on self-efficacy (Std. MD = 2.37; 95% CI = -2.61 to 7.35; P = .35), LDL (Std. MD = -1.81; 95% CI = -4.80 to 1.18; P = .24), HDL (Std. MD = -1.15; 95% CI = -2.83 to 0.54; P = .18), BMI (Std. MD = -3.61; 95% CI = -9.48 to 2.26; P = .23), systolic blood pressure (Std. MD = -3.46; 95% CI = -9.03 to 2.12; P = .22), diastolic blood pressure (Std. MD = -2.03; 95% CI = -5.90 to 1.85; P = .31, non-smoker (RR = 1.12; 95% CI = 0.78 to 1.62; P = .53), and physical activity (RR = 1.57; 95% CI = 0.63 to 3.90; P = .33). Conclusions: Text message intervention demonstrates no positive impact on self-efficacy, treatment adherence, and the control of risk factors in patients with coronary heart disease.

Medication reminder applications to improve adherence in coronary heart disease: a randomised clinical trial

Heart ◽  
2018 ◽  
Vol 105 (4) ◽  
pp. 323-329 ◽  
Author(s):  
Karla Santo ◽  
Anna Singleton ◽  
Kris Rogers ◽  
Aravinda Thiagalingam ◽  
John Chalmers ◽  
...  
Keyword(s):  
Clinical Trial ◽  
Coronary Heart Disease ◽  
Heart Disease ◽  
Medication Adherence ◽  
Usual Care ◽  
Mean Difference ◽  
Care Group ◽  
Improve Medication Adherence ◽  
Significant Difference ◽  
Medication Reminder

ObjectiveThe aim of the MEDication reminder APPs to improve medication adherence in Coronary Heart Disease Study was to evaluate the effectiveness and feasibility of using publicly available high-quality medication reminder applications (apps) to improve medication adherence compared with usual care in patients with coronary heart disease (CHD). An additional aim was to examine whether an app with additional features improved adherence further.MethodsPatients with CHD (n=163) were randomised to one of three groups: (1) usual care, (2) a basic app or (3) an advanced app with interactive/customisable features. The primary analysis compared usual care versus app use on the primary outcome of the 8-item Morisky Medication Adherence Scale (MMAS-8) at 3 months. Secondary outcomes included blood pressure and cholesterol levels.ResultsThe mean age was 57.9 years and 87.7% were male. At 3 months, patients using an app had higher adherence (mean MMAS-8 score 7.11) compared with the usual care group (mean MMAS-8 score 6.63) with a mean difference between groups of 0.47 (95% CI 0.12 to 0.82, p=0.008). There was no significant difference in patients using the basic app versus the advanced app (mean difference −0.16, 95% CI −0.56 to 0.24, p=0.428). There were no significant differences in secondary clinical outcome measures.ConclusionPatients with CHD who used medication reminder apps had better medication adherence compared with usual care, and using apps with additional features did not improve this outcome further. These data suggest medication apps are likely to help patients with chronic health conditions adhere to medicines, but further examination of whether such benefits are sustained is warranted.Clinical trial registration numberACTRN12616000661471; Results.

Improving Medication Adherence in Coronary Heart Disease

2017 ◽  
Vol 19 (11) ◽  
Author(s):  
Leah L. Zullig ◽  
Katherine Ramos ◽  
Hayden B. Bosworth
Keyword(s):  
Coronary Heart Disease ◽  
Heart Disease ◽  
Medication Adherence

Abstract MP77: Projected Impact of Shifting Population Distributions of Blood Pressure on Rates of Coronary Heart Disease, Heart Failure and Stroke: The Atherosclerosis Risk in Communities Study

Circulation ◽  
2013 ◽  
Vol 127 (suppl_12) ◽  
Author(s):  
Shakia T Hardy ◽  
Laura R Loehr ◽  
Kenneth R Butler ◽  
Patricia P Chang ◽  
Aaron R Folsom ◽  
...  
Keyword(s):  
Heart Failure ◽  
Blood Pressure ◽  
Coronary Heart Disease ◽  
African American ◽  
Heart Disease ◽  
Population Distribution ◽  
The United States ◽  
Incidence Rates ◽  
Atherosclerosis Risk In Communities ◽  
Atherosclerosis Risk

Introduction: Rates of cerebrovascular disease, heart failure (HF), and coronary heart disease (CHD), increase progressively as blood pressure rises. Several authors have estimated the theoretical effects of shifting the population distribution of blood pressure; however few studies have examined the degree to which modest decrements in blood pressure affect HF incidence, or included a racially diverse population. Methods: Incident HF was identified by a first hospitalization with discharge diagnosis code of 428.X. Incident hospitalized (definite or probable) CHD and stroke were classified according to protocol. We used multivariable regression to estimate incidence rate differences (IRD) for HF, CHD, and stroke that could be associated with a two mm Hg reduction in systolic blood pressure (SBP) in 15,744 participants from the Atherosclerosis Risk in Communities Study. Results: Over a mean of 18.3 years of follow up, age-adjusted incidence rates for HF, CHD, and stroke were higher among African American than Caucasians (Table 1). After adjusting for antihypertensive use, gender, and age, a two mm Hg decrement in SBP across the total population was associated with an estimated 24/100,000 person-years (PY) and 39/100,000 PY fewer incident HF events in Caucasians and African Americans, respectively. The projected disease reductions were of smaller absolute magnitude for incident CHD and incident stroke. Extrapolation to the African American and Caucasian U.S. populations age greater than 45 years suggests that a two mmHg decrement in SBP could result in approximately 22,000 fewer incident HF events, 15,000 fewer incident CHD events, and 5,000 fewer incident stroke events annually. Conclusion: Our results suggest that modest shifts in SBP, consistent with what could theoretically be achieved through population level lifestyle interventions, could substantially decrease the incidence of HF, stroke, and CHD in the United States, especially among African American populations.

A qualitative participatory study to identify experiences of coronary heart disease patients to support the development of online self-management services

2013 ◽  
Vol 82 (12) ◽  
pp. 1183-1194 ◽  
Author(s):  
Sandra Vosbergen ◽  
Jolien Janzen ◽  
Pieter Jan Stappers ◽  
Myra C.B. van Zwieten ◽  
Joyca Lacroix ◽  
...  
Keyword(s):  
Coronary Heart Disease ◽  
Heart Disease ◽  
Self Management ◽  
Management Services

scholarly journals The Effectiveness of Self-Management of Hypertension in Adults Using Mobile Health: Systematic Review and Meta-Analysis

10.2196/17776 ◽  
2020 ◽  
Vol 8 (3) ◽  
pp. e17776 ◽  
Author(s):  
Ran Li ◽  
Ning Liang ◽  
Fanlong Bu ◽  
Therese Hesketh
Keyword(s):  
Systematic Review ◽  
Blood Pressure ◽  
Health Care ◽  
Medication Adherence ◽  
Mobile Health ◽  
Meta Analysis ◽  
Self Management ◽  
Narrative Synthesis ◽  
Management Behavior ◽  
Mhealth Intervention

Background Effective treatment of hypertension requires careful self-management. With the ongoing development of mobile technologies and the scarcity of health care resources, mobile health (mHealth)–based self-management has become a useful treatment for hypertension, and its effectiveness has been assessed in many trials. However, there is a paucity of comprehensive summaries of the studies using both qualitative and quantitative methods. Objective This systematic review aimed to measure the effectiveness of mHealth in improving the self-management of hypertension for adults. The outcome measures were blood pressure (BP), BP control, medication adherence, self-management behavior, and costs. Methods A systematic search was conducted using 5 electronic databases. The snowballing method was used to scan the reference lists of relevant studies. Only peer-reviewed randomized controlled trials (RCTs) published between January 2010 and September 2019 were included. Data extraction and quality assessment were performed by 3 researchers independently, adhering to the validation guideline and checklist. Both a meta-analysis and a narrative synthesis were carried out. Results A total of 24 studies with 8933 participants were included. Of these, 23 studies reported the clinical outcome of BP, 12 of these provided systolic blood pressure (SBP) and diastolic blood pressure (DBP) data, and 16 articles focused on change in self-management behavior and medication adherence. All 24 studies were included in the narrative synthesis. According to the meta-analysis, a greater reduction in both SBP and DBP was observed in the mHealth intervention groups compared with control groups, −3.78 mm Hg (P<.001; 95% CI −4.67 to −2.89) and −1.57 mm Hg (P<.001; 95% CI −2.28 to −0.86), respectively. Subgroup analyses showed consistent reductions in SBP and DBP across different frequencies of reminders, interactive patterns, intervention functions, and study duration subgroups. A total of 16 studies reported better medication adherence and behavioral change in the intervention groups, while 8 showed no significant change. Six studies included an economic evaluation, which drew inconsistent conclusions. However, potentially long-term financial benefits were mentioned in all economic evaluations. All studies were assessed to be at high risk of bias. Conclusions This review found that mHealth self-management interventions were effective in BP control. The outcomes of this review showed improvements in self-management behavior and medication adherence. The most successful mHealth intervention combined the feature of tailored messages, interactive communication, and multifaceted functions. Further research with longer duration and cultural adaptation is necessary. With increasing disease burden from hypertension globally, mHealth offers a potentially effective method for self-management and control of BP. mHealth can be easily integrated into existing health care systems. Trial Registration PROSPERO CRD42019152062; https://www.crd.york.ac.uk/prospero/display_record.php?RecordID=152062

scholarly journals Hypertension and coronary artery disease in non-insulin dependent diabetes--cause and effect?

1992 ◽  
Vol 3 (4) ◽  
pp. S126
Author(s):  
J S Yudkin
Keyword(s):  
Blood Pressure ◽  
Coronary Heart Disease ◽  
Heart Disease ◽  
Disease Risk ◽  
Linear Increase ◽  
Randomized Controlled Studies ◽  
Patients With Diabetes ◽  
Insulin Dependent ◽  
Artery Disease ◽  
Log Linear

There is a log-linear increase in the risk of coronary heart disease with elevation of levels of blood pressure. Allowing for the phenomenon of regression dilution bias, this corresponds to around a 20 to 25% increase in risk for each 5 to 6 mm Hg elevation in usual diastolic blood pressure. In diabetic subjects, a similar relationship occurs, but of somewhat lesser degree. Recent overviews of therapy suggest that in nondiabetics, reducing blood pressure reverses around 50% of the excess coronary heart disease risk, but this has not yet been conclusively shown in patients with diabetes. The reduction in risk with therapy is a prerequisite to defining the antecedent as a causal influence on outcome, but it is as likely that the incomplete reversibility of excess risk represents other pathways of connection between hypertension and coronary heart disease as a consequent of iatrogenic effects of current treatments. Several alternative mechanisms are outlined, and the suggestion is made that only in the context of randomized controlled studies could the possible benefits on coronary heart disease of agents influencing such mechanisms be assessed.

Sign in / Sign up

Export Citation Format

Share Document