Mobile-Application-Based Interventions for Patients With Hypertension and Ischemic Heart Disease: A Systematic Review

10.1097/jnr.0000000000000382

Jin Yi CHOI；Heejung CHOI；GyeongAe SEOMUN；Eun Jung KIM

mobile applications ； hypertension ； myocardial ischemia ； systematic review

The Journal of Nursing Research

28卷5期（2020 / 10 / 01）

1 - 19

英文

Background: Hypertension and ischemic heart disease are major causes of adult mortality. Related interventions to manage these conditions are important to implement during long, symptom-free periods. The recent proliferation of smartphones has spawned numerous health interventions that rely on mobile applications. Purpose: This systematic review was designed to summarize and analyze research on interventions using mobile applications for patients with hypertension and ischemic heart disease. Methods: We searched for related studies published from January 2006 to August 2017 on MEDLINE,EMBASE, CINAHL, and three Korean databases. Seventeen studies were identified and evaluated against eligibility criteria that included a focus on patients with hypertension or ischemic heart disease and a discussion of the detailed effects of a mobile-app-based intervention. All of the identified studies were evaluated qualitatively using a methodology checklist. Results: Twelve of the 17 studies were deemed as of acceptable quality according to the Scottish Intercollegiate Guideline Network quality assessment. According to the National Institutes of Health quality assessment tool, one article was of fair quality and four articles were of poor quality. Monitoring, education, and reminders were identified as application interventions. The effects of the app interventions were analyzed according to physiological factors, cognitive and behavioral factors, and psychological factors. Of the seven studies that measured blood pressure in patients with hypertension, five studies reported that the app-based interventions reduced blood pressure. Two of three studies showed a significant decrease of body mass index in patients with ischemic heart disease after the app-based interventions compared to the control group. Five of seven studies reported a significant change in medication adherence. Several studies showed different outcomes according to the disease, but the limited number of eligible studies was insufficient to demonstrate a conclusive effect. Conclusions: To ensure the long-term effects of mobile-application-based interventions, healthcare professionals should consider the functions of mobile applications. Moreover, because the focus of these interventions may differ based on the nature of the disease, it is recommended that the composition of interventions be tailored to the specific disease.

1. Agbor-Etang, B. B.,Setaro, J. F.(2015).Management of hypertension in patients with ischemic heart disease.Current Cardiology Reports,17(12),119.
2. Albini, F.,Liu, X.,Torlasco, C.,Soranna, D.,Faini, A.,Ciminaghi, R.,Celsi, A.,Benedetti, M.,Zambon, A.,di Rienzo, M.,Parati, G.(2016).An ICT and mobile health integrated approach to optimize patients' education on hypertension and its managementby physicians: The patients optimal strategy of treatment(POST)pilot study.Annual International Conference of the IEEE Engineering in Medicine and Biology Society,2016,517-520.
3. Ammenwerth, E.,Woess, S.,Baumgartner, C.,Fetz, B.,van derHeidt, A.,Kastner, P.,Modre-Osprian, R.,Welte, S.,Poelzl,G.(2015).Evaluation of an integrated telemonitoring surveillance system in patients with coronary heart disease.Methodsof Information in Medicine,54(5),388-397.
4. Anderson, K.,Burford, O.,Emmerton, L.(2016).Mobile healthapps to facilitate self-care: A qualitative study of user experiences.PLOS ONE,11(5),e0156164.
5. Anglada-Martinez, H.,Martin-Conde, M.,Rovira-Illamola, M.,Sotoca-Momblona, J. M.,Sequeira, E.,Aragunde, V.,Moreno,M. A.,Catalan, M.,Codina-Jane, C.(2016).Feasibility andpreliminary outcomes of a web and smartphone-based medication self-management platform for chronically ill patients.Journal of Medical Systems,40(4),99.
6. Barnason, S.,White-Williams, C.,Rossi, L. P.,Centeno, M.,Crabbe, D. L.,Lee, K. S.,McCabe, N.,Nauser, J.,Schulz, P.,Stamp, K.,Wood, K.,American Heart Association,Council on Cardiovascular and Stroke Nursing,Council on Cardiovascular Disease in the Young,Council on Clinical Cardiology,Stroke Council(2017).Evidence for therapeutic patient education interventionsto promote cardiovascular patient self-management: A scientificstatement for healthcare professionals from the AmericanHeart Association.Circulation. Cardiovascular Quality and Outcomes,10(6),e000025.
7. Bengtsson, U.,Kjellgren, K.,Hallberg, I.,Lindwall, M.,Taft, C.(2016).Improved blood pressure control using an interactivemobile phone support system.The Journal of Clinical Hypertension,18(2),101-108.
8. Blasco, A.,Carmona, M.,Fernandez-Lozano, I.,Salvador, C. H.,Pascual, M.,Sagredo, P. G.,Somolinos, R.,Muñoz, A.,GarcíaLópez, F.,Escudier, J. M.,Mingo, S.,Toquero, J.,Moñivas, V.,González, M. A.,Fragua, J. A.,López-Rodríguez, F.,Monteagudo,J. L.,Alonso-Pulpón, L.(2012).Evaluation of a telemedicine service for the secondary prevention of coronary artery disease.Journal of Cardiopulmonary Rehabilitation and Prevention,32(1),25-31.
9. Bloss, C. S.,Wineinger, N. E.,Peters, M.,Boeldt, D. L.,Ariniello, L.,Kim, J. Y.,Sheard, J.,Komatireddy, R.,Barrett, P.,Topol, E. J.(2016).A prospective randomized trial examining health care utilization in individuals using multiple smartphone-enabled biosensors.PeerJ,4,e1554.
10. Bokhour, B. G.,Berlowitz, D. R.,Long, J. A.,Kressin, N. R.(2006).How do providers assess antihypertensive medication adherencein medical encounters?.Journal of General Internal Medicine,21,577-583.
11. Brzan, P. P.,Rotman, E.,Pajnkihar, M.,Klanjsek, P.(2016).Mobile applications for control and self management of diabetes:A systematic review.Journal of Medical Systems,40(9),210.
12. Campbell, D. J.,Coller, J. M.,Gong, F. F.,McGrady, M.,Prior, D. L.,Boffa, U.,Shiel, L.,Liew, D.,Wolfe, R.,Owen, A. J.,Krum, H.,Reid, C. M.,Reid, C. M.(2018).Risk factor management ina contemporary Australian population at increased cardiovascular disease risk.Internal Medicine Journal,48(6),688-698.
13. Davidson, T. M.,McGillicuddy, J.,Mueller, M.,Brunner-Jackson, B.,Favella, A.,Anderson, A.,Torres, M.,Ruggiero, K. J.,Treiber, F.A.,Treiber, F. A.(2015).Evaluation of an mHealth medicationregimen self-management program for African American andHispanic uncontrolled hypertensives.Journal of Personalized Medicine,5(4),389-405.
14. Davies, C. A.,Spence, J. C.,Vandelanotte, C.,Caperchione, C. M.,Mummery, W. K.(2012).Meta-analysis of internet-deliveredinterventions to increase physical activity levels.The International Journal of Behavioral Nutrition and Physical Activity,9,52.
15. Fu, H.,McMahon, S. K.,Gross, C. R.,Adam, T. J.,Wyman, J. F.(2017).Usability and clinical efficacy of diabetes mobile applications for adults with type 2 diabetes: A systematic review.Diabetes Research and Clinical Practice,131,70-81.
16. Fukuoka, Y.,Vittinghoff, E.,Jong, S. S.,Haskell, W.(2010).Innovation to motivation-Pilot study of a mobile phone intervention to increase physical activity among sedentary women.Preventive Medicine,51(3-4),287-289.
17. Hallberg, I.,Ranerup, A.,Kjellgren, K.(2015).Supporting theself-management of hypertension: Patients’ experiences ofusing a mobile phone-based system.Journal of Human Hypertension,30(2),141-146.
18. Hincapie, A. L.,Gupta, V,Brown, S. A.,Metzger, A. H.(2019).Exploring perceived barriers to medication adherence and theuse of mobile technology in underserved patients with chronic conditions.Journal of Pharmacy Practice,32(2),147-153.
19. Ho, P. M.,Bryson, C. L.,Rumsfeld, J. S.(2009).Medication adherence: Its importance in cardiovascular outcomes.Circulation,119(23),3028-3035.
20. Innovatemedtec. (2018). Health and wellness apps. https://innovatemedtec.com/digital-health/health-and-wellness-apps
21. Johnson, H. M.,Warner, R. C.,LaMantia, J. N.,Bowers, B. J.(2016)."I have to live like I'm old." Young adults' perspectiveson managing hypertension: A multi-center qualitative study.BMC Family Practice,17,Article number 31.
22. Johnston, N.,Bodegard, J.,Jerstrom, S.,Akesson, J.,Brorsson, H.,Alfredsson, J.,Albertsson, P. A.,Karlsson, J. E.,Varenhorst,C.(2016).Effects of interactive patient smartphone supportapp on drug adherence and lifestyle changes in myocardial infarction patients: A randomized study.American Heart Journal,178,85-94.
23. Joseph, N.,Chiranjeevi, M.,Sen, S.,Singh, P.,Saini, M.,Beg, S.(2016).Awareness on hypertension and its self-managementpractices among hypertensive patients attending outreachclinics of a medical college in South India.Kathmandu University Medical Journal,14(55),202-209.
24. Karhula, T.,Vuorinen, A. L.,Rääpysjärvi, K.,Pakanen, M.,Itkonen, P.,Tepponen, M.,Junno, U.-M.,Jokinen, T.,van Gils, M.,Lähteenmäki,J.,Kohtamäki, K.,Saranummi, N.(2015).Telemonitoring andmobile phone-based health coaching among Finnish diabeticand heart disease patients: Randomized controlled trial.Journalof Medical Internet Research,17(6),e153.
25. Kerr, S.,Watson, H.,Tolson, D.,Lough, M.,Brown, M.(2006).Smoking after the age of 65 years: A qualitative explorationof older current and former smokers’ views on smoking, stopping smoking, and smoking cessation resources and services.Health & Social Care in the Community,14(6),572-582.
26. Kjeldsen, S.,Feldman, R. D.,Lisheng, L.,Mourad, J. J.,Chiang, C. E.,Zhang, W.,Wu, Z.,Li, W.,Williams, B.(2014).Updated nationaland international hypertension guidelines: A review of currentrecommendations.Drugs,74(17),2033-2051.
27. Lee, J.,Yoon, W.,Cho, S.-i.,Cho, Y.(2016).A strategic consideration on chronic disease prevention and management throughmHealth utilization.The Korean Journal of Public Health,53(1),7-16.
28. Lee, S. Q.,Raamkumar, A. S.,Li, J.,Cao, Y.,Witedwittayanusat, K.,Chen, L.,Theng, Y. L.(2018).Reasons for primary medication nonadherence: A systematic review and metric analysis.Journal of Managed Care & Specialty Pharmacy,24(8),778-794.
29. Lee, Y. H.,Hur, S. H.,Sohn, J.,Lee, H. M.,Park, N. H.,Cho, Y. K.,Park, H. S.,Yoon, H. J.,Kim, H.,Nam, C. W.,Kim, Y. N.,Kim, K. B.(2013).Impact of home-based exercise training withwireless monitoring on patients with acute coronary syndromeundergoing percutaneous coronary intervention.Journal ofKorean Medical Science,28(4),564-568.
30. Machado, G. C.,Pinheiro, M. B.,Lee, H.,Ahmed, O. H.,Hendrick,P.,Williams, C.,Kamper, S. J.(2016).Smartphone apps forthe self-management of low back pain: A systematic review.Best Practice & Research Clinical Rheumatology,30(6),1098-1109.
31. Maher, C. A.,Lewis, L. K.,Ferrar, K.,Marshall, S.,De Bourdeaudhuij,I.,Vandelanotte, C.(2014).Are health behavior change interventions that use online social networks effective? A systematicreview.Journal of Medical Internet Research,16(2),e40.
32. Martin, S. S.,Feldman, D. I.,Blumenthal, R. S.,Jones, S. R.,Post,W. S.,McKibben, R. A.,Michos, E. D.,Ndumele, C. E.,Ratchford, E.V.,Coresh, J.,Blaha, M. J.(2015).mActive: A randomized clinical trial of an automated mHealth intervention for physical activity promotion.Journal of the American Heart Association,4(11),e002239.
33. Mertens, A.,Brandl, C.,Miron-Shatz, T.,Schlick, C.,Neumann, T.,Kribben, A.,Meister, S.,Diamantidis, C.,Albrecht, U.-V.,Becker, S.(2016).A mobile application improves therapyadherence rates in elderly patients undergoing rehabilitation:A crossover design study comparing documentation via iPadwith paper-based control.Medicine,95(36),e4446.
34. Moorhead, P.,Zavala, A.,Kim, Y.,Virdi, N. S.(2017).Efficacyand safety of a medication dose reminder feature in a digitalhealth offering with the use of sensor-enabled medicines.Journal of the American Pharmacists Association,57(2),155-161.
35. National Institutes of Health. (2018). Study quality assessmenttools. https://www.nhlbi.nih.gov/health-topics/study-quality-assessment-tools
36. Neubeck, L.,Lowres, N.,Benjamin, E. J.,Freedman, S. B.,Coorey, G.,Redfern, J.(2015).The mobile revolution-Using smartphoneapps to prevent cardiovascular disease.Nature Reviews Cardiology,12,350-360.
37. Or, C.,Tao, D.(2016).A 3-month randomized controlled pilot trialof a patient-centered, computer-based self-monitoring systemfor the care of type 2 diabetes mellitus and hypertension.Journal of Medical Systems,40(4),81.
38. Paige, S. R.,Krieger, J. L.,Stellefson, M. L.(2017).The influence ofeHealth literacy on perceived trust in online health communication channels and sources.Journal of Health Communication,22(1),53-65.
39. Patel, S.,Jacobus-Kantor, L.,Marshall, L.,Ritchie, C.,Kaplinski, M.,Khurana, P. S.,Katz, R. J.(2013).Mobilizing your medications:An automated medication reminder application for mobile phonesand hypertension medication adherence in a high-risk urbanpopulation.Journal of Diabetes Science and Technology,7(3),630-639.
40. Ramage, S.,Farmer, A.,Eccles, K. A.,McCargar, L.(2014).Healthy strategies for successful weight loss and weight maintenance:A systematic review.Applied Physiology, Nutrition, and Metabolism,39(1),1-20.
41. Reboussin, D. M.,Allen, N. B.,Griswold, M. E.,Guallar, E.,Hong,Y.,Lackland, D. T.,Miller, E. R., III,Polonsky, T.,ThompsonPaul, A. M.,Vupputuri, S.(2018).Systematic review for the 2017 ACC/AHA/AAPA/ABC/ACPM/AGS/APhA/ASH/ASPC/NMA/PCNA guideline for the prevention, detection, evaluation, and management of high blood pressure in adults: A report of the American college of cardiology/American Heart Associationtask force on clinical practice guidelines.Journal of the American College of Cardiology,71(19),2176-2198.
42. Scottish Intercollegiate Guideline Network. (2018). Methodology.https://www.sign.ac.uk/methodology.html
43. Shawler, C.,Edward, J.,Ling, J.,Crawford, T. N.,Rayens, M. K.(2018).Impact of mother-daughter relationship on hypertensionself-management and quality of life: Testing dyadic dynamicsusing the actor-partner interdependence model.The Journalof Cardiovascular Nursing,33(3),232-238.
44. Shea, B. J.,Grimshaw, J. M.,Wells, G. A.,Boers, M.,Andersson, N.,Hamel, C.,Porter, A. C.,Tugwell, P.,Moher, D.,Bouter, L. M.(2007).Development of AMSTAR: A measurement tool to assessthe methodological quality of systematic reviews.BMC Medical Research Methodology,7(1),10.
45. Siahpush, M.,McNeill, A.,Borland, R.,Fong, G. T.(2006).Socioeconomic variations in nicotine dependence, self-efficacy, and intention to quit across four countries: Findings from the internationaltobacco control (ITC) four country survey.Tobacco Control,15(3,Suppl.),iii71-iii75.
46. Souffront, K.,Gestal, C.,Melkus, G. D.,Richardson, L.(2016).Recognition of asymptomatic hypertension in an urban emergency department: Where are we now?.Advanced Emergency Nursing Journal,38(4),320-326.
47. Statista (2019). Number of smartphone users worldwide from2016 to 2021 (in billions). https://www.statista.com/statistics/330695/number-of-smartphone-users-worldwide/
48. Stuckey, M. I.,Carter, S. W.,Knight, E.(2017).The role of smartphones in encouraging physical activity in adults.International Journal of General Medicine,10,293-303.
49. Suh, H.,Hong, H.,Kim, M.,Yoon, W.,Lee, T.,Jung, J.,Hwang, S.,Cho, Y.(2015).Mhealth apps: The current status of usageand the factors of continuous use.Journal of the HCI Society of Korea,10(1),19-27.
50. Thakkar, J.,Kurup, R.,Laba, T.,Santo, K.,Thiagalingam, A.,Rodgers,A.,Woodward, M.,Redfern, J.,Chow, C. K.(2016).Mobile telephone text messaging for medication adherence in chronic disease: A meta-analysis.JAMA Internal Medicine,176(3),340-349.
51. Thangada, N. D.,Garg, N.,Pandy, A.,Kumar, N.(2018).The emerging role of mobile-health applications in the managementof hypertension.Current Cardiology Reports,20(9),78.
52. Ventola, C. L.(2014).Mobile devices and apps for health care professionals: Uses and benefits.P & T : A Peer-reviewed Journal for Formulary Management,39(5),356-364.
53. Whelton, P. K.,He, J.,Appel, L. J.,Cutler, J. A.,Havas, S.,Kotchen,T. A.,Roccella, E. J.,Stout, R.,Vallbona, C.,Winston, M. C.,Karimbakas, J.,National High Blood Pressure Education Program Coordinating Committee(2002).Primary prevention ofhypertension: Clinical and public health advisory from the national high blood pressure education program.Journal of the American Medical Association,288(15),1882-1888.
54. Whittaker, R.,McRobbie, H.,Bullen, C.,Rodgers, A.,Gu, Y.(2016).Mobile phone-based interventions for smoking cessation.Cochrane Database of Systematic Reviews,4,CD006611.
55. Widmer, R. J.,Allison, T. G.,Lennon, R.,Lopez-Jimenez, F.,Lerman, L. O.,Lerman, A.(2017).Digital health interventionduring cardiac rehabilitation: A randomized controlled trial.American Heart Journal,188,65-72.
56. Wolf, A.,Fors, A.,Ulin, K.,Thorn, J.,Swedberg, K.,Ekman, I.(2016).An eHealth diary and symptom-tracking tool combinedwith person-centered care for improving self-efficacy after adiagnosis of acute coronary syndrome: A substudy of a randomized controlled trial.Journal of Medical Internet Research,18(2),e40.
57. World Health Organization. (2017). Cardiovascular diseases (CVDs).http://www.who.int/news-room/fact-sheets/detail/cardiovasculardiseases-(cvds)
58. Xie, B.,Su, Z.,Zhang, W.,Cai, R.(2017).Chinese cardiovascular disease mobile apps' information types, information quality,and interactive functions for self-management: Systematic review.JMIR mHealth and uHealth,5(12),e195.
59. Zhao, J.,Freeman, B.,Li, M.(2016).Can mobile phone apps influence people's health behavior change? An evidence review.Journal of Medical Internet Research,18(11),e287.