scholarly journals Impact of a Culturally Tailored mHealth Medication Regimen Self-Management Program upon Blood Pressure among Hypertensive Hispanic Adults

2019 ◽  
Vol 16 (7) ◽  
pp. 1226 ◽  
Author(s):  
Jessica Chandler ◽  
Luke Sox ◽  
Kinsey Kellam ◽  
Lauren Feder ◽  
Lynne Nemeth ◽  
...  
Keyword(s):  
Blood Pressure ◽  
Management Program ◽  
Text Messages ◽  
Self Management ◽  
Efficacy Trial ◽  
P Values ◽  
Medical Regimen ◽  
Culturally Tailored ◽  
Significant Difference ◽  
Hispanic Adults

Background: Uncontrolled hypertension (HTN) and medication nonadherence are more prominent among Hispanics compared to non-Hispanic whites and African Americans. Advances in wireless health technology enable real-time monitoring of medication adherence (MA) and blood pressure (BP), facilitating timely patient–provider communication including tailored reinforcement/motivational feedback to patients and quicker titration changes by providers. The purpose of the current study was to conduct a 9-month smartphone-enabled efficacy trial addressing MA and BP control among Hispanic adults with uncontrolled HTN and poor MA. Methods: The research design was a 9-month, two-arm efficacy trial including an experimental (Smartphone Med Adherence Stops Hypertension, SMASH) group and an enhanced standard care (ESC) group. SMASH participants utilized a SMASH app which interfaced with a Bluetooth-enabled BP monitor for BP self-monitoring and an electronic medication tray. The ESC participants received text messages including links to PDFs and brief video clips containing healthy lifestyle tips for attention control. Results: Participants were 54 Hispanic adults (mean age: 46.5 years) with uncontrolled HTN. They were randomly assigned to either the SMASH (n = 26) or ESC group (n = 28). At baseline, no participants had controlled systolic BP (SBP). Baseline group averages for SBP between the SC and SMASH groups did not differ (150.7 and 152.3 mmHg, respectively; p = 0.53). At the 1, 3, 6, and 9-month time points, SBP averages were significantly lower in the SMASH versus SC groups (month 1: 125.3 vs. 140.6; month 3: 120.4 vs. 137.5, month 6: 121.2 vs. 145.7 mmHg; month 9: 121.8 vs. 145.7, respectively; all p-values <0.01). At months 3, 6, and 9 there was a significant difference between the percentage of participants meeting the 7th Joint National Committee cutoffs for SBP control in the SC and SMASH groups (month 3: 62.5 vs. 92.0%; month 6: 57.9 and 94.4%, month 9: 27.8 and 92.3%, respectively; all p-values ≤0.01). Average medical regimen adherence, as indicated by timestamped medication intake and BP monitoring for the SMASH group, ranged from 89.1 to 95.2% across the 9-month trial. Conclusion: Our findings indicate that our culturally tailored smartphone-enabled medical regimen self-management program may be an effective solution for the promotion of MA, resulting in statistically and clinically significant reductions in SBP among Hispanic adults with uncontrolled HTN.

Effect of Patient-Centered Self-Management Program on Blood Pressure, Renal Function Control, and the Quality of Life of Patients With Hypertensive Nephropathy: A Longitudinal Randomized Controlled Trial

2021 ◽  
pp. 109980042110618
Author(s):  
Mei-Chen Lee ◽  
Shu-Fang Vivienne Wu ◽  
Kuo-Cheng Lu ◽  
Wen-Hug Wang ◽  
Yen-Yen Chen ◽  
...  
Keyword(s):  
Quality Of Life ◽  
Blood Pressure ◽  
Controlled Trial ◽  
Management Program ◽  
Self Management ◽  
Control Group ◽  
Patient Centered ◽  
Hypertensive Nephropathy ◽  
Experimental Group

This longitudinal study with a randomized controlled trial evaluated the long-term effectiveness of the patient-centered self-management intervention program on the control of blood pressure and renal function, as well as the quality of life of patients with hypertensive nephropathy. The control group ( n = 38) received usual care while the experimental group ( n = 38) participated in a patient-centered self-management program. After the pre-test, the intervention was performed with the experimental group once a week for a total of 4 weeks. Then, the post-test was performed 1, 3, and 6 months later. A questionnaire was used to collect the demographic data and disease characteristics, laboratory data, and quality of life scale. This study tracked three time points (i.e., 1, 3, and 6 months) after the intervention and found that the experimental group achieved significant results in controlling systolic blood pressure ( p < 0.001), diastolic blood pressure ( p = 0.007), and eGFR ( p = 0.013). Significant results were achieved in the overall quality of life ( p < 0.001) and the quality of life in the physical (PHC; p < 0.001) and mental health components (MHC; p < 0.001). Furthermore, the effects in the experimental group lasted for as long as 6 months and were better than those in the control group. Moreover, this program can provide nursing staff with a reference different from traditional health education methods.

scholarly journals mHealth medication and blood pressure self-management program in Hispanic hypertensives: a proof of concept trial

2013 ◽  
pp. 1 ◽  
Author(s):  
John Sieverdes ◽  
Gregoski ◽  
Sachin Patel ◽  
Williamson ◽  
Brunner-Jackson ◽  
...  
Keyword(s):  
Blood Pressure ◽  
Management Program ◽  
Self Management ◽  
Proof Of Concept

scholarly journals Smartphone-Based Remote Self-Management of Chronic Low Back Pain: A Preliminary Study

2019 ◽  
Vol 2019 ◽  
pp. 1-7 ◽  
Author(s):  
Jingyi Yang ◽  
Quan Wei ◽  
Yanlei Ge ◽  
Lijiao Meng ◽  
Meidan Zhao
Keyword(s):  
Low Back Pain ◽  
Back Pain ◽  
Chronic Low Back Pain ◽  
Bodily Pain ◽  
Management Program ◽  
Self Management ◽  
Control Group ◽  
Positive Trend ◽  
Low Back ◽  
Significant Difference

Objective. To assess the additional effect of self-management on physiotherapy via the use of APPS on management of chronic low back pain. Method. A single-blinded randomized control trial was conducted. 8 participants (male: 4; female: 4) were recruited from the Rehabilitation Clinic of The Hong Kong Polytechnic University. Participants in the treatment group received self-management plus physiotherapy and the control group received physiotherapy only. Assessment was carried out pretreatment, midterm (week 2), and posttreatment (week 4), including Visual Analog Scale (VAS), Pain Self-Efficacy Questionnaire (PSEQ), Roland Morris Disability Questionnaire (RMDQ), and SF36. Results. Compared with the physiotherapy group, the self-management plus physiotherapy group had significance in PSEQ (p=0.035), RMDQ (p=0.035), SF36-Bodily Pain (p=0.008), and SF36-Mental Health (p=0.013). VAS showed a positive trend although there was no significant difference. Conclusion. This pilot study indicated that smartphone APPS-based self-management program appears to bring additional benefits to physiotherapy for patients with CLBP. Self-management is a potential approach for people with CLBP.

scholarly journals Telephone-based depression self-management in Hispanic adults with epilepsy: a pilot randomized controlled trial

2021 ◽  
Author(s):  
Tanya M Spruill ◽  
Daniel Friedman ◽  
Laura Diaz ◽  
Mark J Butler ◽  
Keith S Goldfeld ◽  
...  
Keyword(s):  
Depressive Symptoms ◽  
Usual Care ◽  
Controlled Trial ◽  
Unmet Need ◽  
Management Program ◽  
Adverse Outcomes ◽  
Retention Rates ◽  
Self Management ◽  
Consent Rate ◽  
Hispanic Adults

Abstract Depression is associated with adverse outcomes in epilepsy but is undertreated in this population. Project UPLIFT, a telephone-based depression self-management program, was developed for adults with epilepsy and has been shown to reduce depressive symptoms in English-speaking patients. There remains an unmet need for accessible mental health programs for Hispanic adults with epilepsy. The purpose of this study was to evaluate the feasibility, acceptability, and effects on depressive symptoms of a culturally adapted version of UPLIFT for the Hispanic community. Hispanic patients with elevated depressive symptoms (n = 72) were enrolled from epilepsy clinics in New York City and randomized to UPLIFT or usual care. UPLIFT was delivered in English or Spanish to small groups in eight weekly telephone sessions. Feasibility was assessed by recruitment, retention, and adherence rates and acceptability was assessed by self-reported satisfaction with the intervention. Depressive symptoms (PHQ-9 scores) were compared between study arms over 12 months. The mean age was 43.3±11.3, 71% of participants were female and 67% were primary Spanish speakers. Recruitment (76% consent rate) and retention rates (86–93%) were high. UPLIFT participants completed a median of six out of eight sessions and satisfaction ratings were high, but rates of long-term practice were low. Rates of clinically significant depressive symptoms (PHQ-9 ≥5) were lower in UPLIFT versus usual care throughout follow-up (63% vs. 72%, 8 weeks; 40% vs. 70%, 6 months; 47% vs. 70%, 12 months). Multivariable-adjusted regressions demonstrated statistically significant differences at 6 months (OR = 0.24, 95% CI, 0.06–0.93), which were slightly reduced at 12 months (OR = 0.30, 95% CI, 0.08–1.16). Results suggest that UPLIFT is feasible and acceptable among Hispanic adults with epilepsy and demonstrate promising effects on depressive symptoms. Larger trials in geographically diverse samples are warranted.

scholarly journals Investigating the Effectiveness of Self-management Program based on 5A Model on Fatigue and Dyspnea in Patients with Heart Failure

2021 ◽  
Author(s):  
Maryam Hajmohamadi ◽  
Sakineh Sabzvari ◽  
Yones Jahani ◽  
Zahra Imani- Goghary
Keyword(s):  
Quality Of Life ◽  
Heart Failure ◽  
Management Program ◽  
T Test ◽  
Trial Registration ◽  
Self Management ◽  
Paired Sample ◽  
Significant Difference ◽  
Patients With Heart Failure

Abstract Background: Some symptoms such as fatigue and dyspnea decrease the quality of life in patients with heart failure. The effectiveness of self-management programs on management chronic conditions was discussed. So, this study aimed to investigate the effectiveness of self-management program based on 5A model on fatigue and dyspnea in patients with heart failure.Materials and Methods: In this clinical trial study, 60 patients with heart failure were included. The intervention group underwent self-management program based on 5A model and the control group received routine care. All the enrolled patients were evaluated once at baseline and once after 3 months using fatigue severity and Borg dyspnea scales. The obtained data were analyzed using SPSS software version 16 by descriptive statistics and independent t-test, covariance test, and paired sample t- test. The significance level was set at 0.05.Results: There was no significant difference in the mean scores of fatigue and dyspnea at the beginning of the study between control and intervention groups (p>0.05), but 3 months after intervention a significant difference was found in mean scores of fatigue and dyspnea between two groups, (p<0.05). The difference between pre- and post-intervention scores in terms of the dyspnea and fatigue variables was significant based on the result of paired sample t- test (p<0.05).Conclusion: according to the results of this study, self-management program based on 5A Model can be used to reduce the severity of fatigue and dyspnea as well as improve the quality of life in patients with heart failure. Trial registration number: IRCT20141109019862N8 Trial registration date: 11/Aug/2019First participant enrollment: 30 /Sep/ 2019:

scholarly journals Mobile health strategies for blood pressure self-management in urban populations with digital barriers: systematic review and meta-analyses

2021 ◽  
Vol 4 (1) ◽  
Author(s):  
Elaine C. Khoong ◽  
Kristan Olazo ◽  
Natalie A. Rivadeneira ◽  
Sneha Thatipelli ◽  
Jill Barr-Walker ◽  
...  
Keyword(s):  
Blood Pressure ◽  
Educational Attainment ◽  
Mobile Health ◽  
Text Messaging ◽  
Randomized Clinical Trials ◽  
Digital Health ◽  
Self Management ◽  
Significant Difference ◽  
Meta Analyses ◽  
The Impact

AbstractMobile health (mHealth) technologies improve hypertension outcomes, but it is unknown if this benefit applies to all populations. This review aimed to describe the impact of mHealth interventions on blood pressure outcomes in populations with disparities in digital health use. We conducted a systematic search to identify studies with systolic blood pressure (SBP) outcomes located in urban settings in high-income countries that included a digital health disparity population, defined as mean age ≥65 years; lower educational attainment (≥60% ≤high school education); and/or racial/ethnic minority (<50% non-Hispanic White for US studies). Interventions were categorized using an established self-management taxonomy. We conducted a narrative synthesis; among randomized clinical trials (RCTs) with a six-month SBP outcome, we conducted random-effects meta-analyses. Twenty-nine articles (representing 25 studies) were included, of which 15 were RCTs. Fifteen studies used text messaging; twelve used mobile applications. Studies were included based on race/ethnicity (14), education (10), and/or age (6). Common intervention components were: lifestyle advice (20); provision of self-monitoring equipment (17); and training on digital device use (15). In the meta-analyses of seven RCTs, SBP reduction at 6-months in the intervention group (mean SBP difference = −4.10, 95% CI: [−6.38, −1.83]) was significant, but there was no significant difference in SBP change between the intervention and control groups (p = 0.48). The use of mHealth tools has shown promise for chronic disease management but few studies have included older, limited educational attainment, or minority populations. Additional robust studies with these populations are needed to determine what interventions work best for diverse hypertensive patients.

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