Digital Health Technology For Treatment of Diabetes, Heart Disease and Hypertension
Digital Health Revolution in Blood Pressure Control
At-home hypertension monitoring devices are dramatically improving blood pressure control.
By Jennifer J. Brown, PhD
Don't Miss This
Sign Up for OurHeart HealthNewsletter
Thanks for signing up!You might also like these other newsletters:
Only half of the 76 million adults in the United States who have hypertension have their blood pressure (BP) under control and new devices that track and respond to high BP levels are coming to market at a rapid clip.
Now evidence from a peer-reviewed medical study that at least one such approach works, offers hope that technology plus on-call expert networks may soon help those living with one of the nation's most common and deadly medical conditions. High BP is a contributor to heart diseases like coronary heart disease, stroke and heart failure that together cause 600,000 deaths each year in the United States.
The study published in JAMA looked at the impact of a setup that costs patients under 200 dollars but brings benefits for patients — 27 percent more patients had their BP under control.
New devices are coming on the market every day. Two new monitoring devices announced last week at the consumer electronics and technology industry’s annual mid-year event, CE Week, in New York City — QardioCore and QardioArm — track blood pressure, heart rate, and EKG readings. They can synch via iPhone and iPAD to be shared with loved ones or healthcare providers. "It will have an incredible impact on patients providing them with short and direct feedback on how the things they do impact their health," said Marco Peluso, cofounder of Qardio in San Francisco.
Digital technologies are not only making it easier to track health conditions like high blood pressure at home, they are helping patients feel more empowered. "Patients these days are no longer blind when it comes to medicine — a lot of people want to be involved in their care and just want to feel better," said Michelle Mead Salley BSN, RN, nurse coordinator at the Beaumont Atrial Fibrillation Center in Royal Oak, Michigan.
New research shows that at-home monitoring and remote data transfer with devices like these actually work well, significantly improving blood pressure control long-term, according to the study from HealthPartners Institute for Education and Research, published today in JAMA. The 18-month HyperLink trial compared usual care with a new intervention: at-home BP measurements, digital data transfer, and telephone consultations with providers.
For the telemonitored group, pharmacists were able to provide real-time case management and counseling. They changed patients’ medications as needed to intensify therapy, and get readings down to a set BP goal.
Benefits Outweigh Costs for Digital Devices
Using new digital technology is not as costly as you might expect.
"A blood pressure monitor very similar to the one we used in the study can be bought online for about to . A telemonitor with transmitting capabilities is more expensive, around 0," said researcher Karen Margolis, MD, MPH, a physician researcher at HealthPartners Institute in Minneapolis, Minnesota.
Costs to the healthcare system are also modest, considering the benefits to patient health. "All told, we estimate that the costs of 12 months of telemonitoring and pharmacist care would cost a health system about ,350 at prevailing market rates," Dr. Margolis said.
The telemonitoring HyperLink study included 450 patients with previously uncontrolled BP, and reported significant gains in health status:
- 27 percent more of the telemonitored group participants than the usual care group had their BP under control at six months and 12 months after the study began.
- 72 percent of the telemonitored group had their BP under control compared with only 57 percent of the usual care group at the 18-month follow-up.
- More of the telemonitored group took their medications as directed, and expressed increased confidence in communicating with their healthcare providers and keeping their BP controlled.
"The patients in our study’s telemonitoring group were more satisfied with some aspects of their care than patients in the usual care group. They felt their clinicians listened to them more carefully, explained things more clearly, and respected what they said," according to Margolis.
The digital health approach kept communication open and resulted in better outcomes. Margolis added, "[Patients] also had more confidence in their ability to manage their own hypertension: being able to communicate with their health care team, integrating blood pressure monitoring into their routine, following their medication regimen, and overall being able to keep their blood pressure under control."
New Tech Empowers Atrial Fibrillation, Afib, Patients
Using a digital health approach now benefits patients with many different heart conditions. For the 3 million people in the United States with the irregular heartbeat known as atrial fibrillation (afib), uncontrolled hypertension raises the risk of life-threatening complications like heart failure, and contributes to a five-fold increased risk for stroke.
Afib patients can now use digital monitoring devices to show when they are having an irregular heartbeat, which nurse coordinator Salley, of the Beaumont Atrial Fibrillation Center, said can be helpful in detecting asymptomatic afib. "After an ablation [proceedure to treat afib], a very symptomatic patient may no longer feel their normal afib symptoms and feel great, not knowing that they are having afib." Patients can use a hand-held portable atrial fibrillation detector, the AfibAlert™ with an App for iPhone, to make sure they know when they are having symptoms.
Salley gets the call when the irregular heartbeat happens, so that "we can see them in the office right away to confirm their diagnosis" — demonstrating one key advantage to home monitoring.
When she works with her patients with afib, Salley said, "We encourage all patients who have hypertension — which is the majority of our patients — to purchase a blood pressure cuff. Patients usually keep a blood pressure log on their own without us even telling them."
At-home monitoring is empowering for patients, according to Salley. "Symptomatic AF patients feel terrible and will do anything to feel better. Logging their blood pressure is one thing that they can do to feel in control," she said, adding that while monitoring BP does not necessarily reduce stroke risk, it can make a patient more aware of their own health signs and signals.
"Patients that are interested in their diagnoses and are on top of their chronic conditions make great patients and seem to do well overall," she said.
Cardiologists Embrace the Digital Health Revolution
At-home monitoring digital monitoring devices with data transfer capability benefit healthcare providers as well as patients, said cardiologist Reena Pande, MD. "I often ask my patients to monitor their BP at home with a home monitoring device. This is particularly helpful in patients who we think might have 'white coat hypertension' where the blood pressure is elevated when they come to see their doctor, but is really normal when they are at home," said Dr. Pande, who is an Everyday Health columnist, Instructor at Harvard Medical School in Boston, and medical director of the Vascular Diagnostic Laboratory at Brigham and Women's Hospital.
Using wireless devices for remote monitoring of heart conditions is a key to improving care for patients with heart failure. "At our hospital, we have a home monitoring program for patients with congestive heart failure, who can measure their weight, blood pressure, and heart rate at home via wireless devices that transmit to a team of nurses," Pande said. For the cardiologist, this information helps catch problems early and, Pande noted, is "allowing us to keep these patients out of the hospital."
She believes at-home devices and web-based platforms can improve cardiac disease management and even help with mental health issues common to many heart patients, with one caveat: Sometimes the devices actually cause patients to be more anxious.
"I do have some patients who monitor blood pressure so frequently that the anxiety around monitoring may actually make the blood pressure worse," Pande said.
But the benefits of the new devices outweigh potential risks, she said: "I think that patients feel empowered with the information that comes with home monitoring devices and taking charge of their health."
Remote Monitoring Augments the Doctor Visit
Cardiologist William T. Abraham, MD, FACP also endorses remote monitoring, "I encourage all of my patients with high blood pressure to measure their blood pressure and heart rate at home. It encourages adherence to medications and healthy lifestyle and allows for remote monitoring of the adequacy of their medical therapy." Dr. Abraham is an Everyday Health columnist and Professor of Medicine, Physiology, and Cell Biology, Director of the Division of Cardiovascular Medicine at The Ohio State University in Columbus, OH.
Even patients using digital monitoring devices still need to go to the doctor. "In our study, we didn’t find fewer office visits to doctors, even though we thought that might happen at the beginning of the study. This result suggests that telemonitoring augments, rather than replaces, physician visits," said Margolis.
"We need to think innovatively about how we can take advantage of the current excitement in the digital health arena to help our patients get healthy and stay healthy outside the walls of the traditional health care system," added Pande.
TELL US: Do you use a digital device or new App to improve your health, or to track a medical condition for yourself or a loved one? Please share your views in the comment box below.
Video: Best Health Tech Gadgets 2019 on Amazon
Watch Kendall Jenner Eat McDonald’s, Pal Around with Gigi Hadid, and More in This BTS FashionVideo
A message, very carefully put, to the Saudi king
Teach Your Kids the Gift of Giving
10 Winning Looks with Layered Bob Hairstyles: Women Short Hair Cuts
How to Make a Simple Beverage Can Stove
9 Recipes – Low in Calories, High on Flavor
Valentines Day Recovery
Matt Smith Talks About The Crown Pay Disparity: It Was A Grave Mistake
Men’s Smart Winter Boots
7 Things That Raise Risks of Blood Clots and DVT
Business Insider is hiring a paid weekend news intern
6 Ways to Improve Your Health, Now
Government backs artificial sperm use