Details

Autor(en) / Beteiligte

• DiCarlo, L
• Naik, R
• Macey, N
• West, R.J
• Godbehere, P
• Thurston, S
• Fox, R
• Singh, I
• Kim, Y.A

Titel

PE.03. Passive and automatic assessment of medication adherence and activities of daily living via digital health sensors and analytics: a registry study in uncontrolled hypertensive patients

Ist Teil von

• Journal of human hypertension, 2015-10, Vol.29 (10), p.646

Ort / Verlag

Nature Publishing Group

Erscheinungsjahr

2015

Quelle

Free E-Journal (出版社公開部分のみ）

Beschreibungen/Notizen

• Background: NICE guidelines advise ascertainment of adherence and exercise patterns for blood pressure (BP) management. Yet, practitioners often have no objective means to measure these parameters. Novel CE-marked devices have been developed to capture and share information about medication-taking and activities of daily living (ADL), through an ingestible sensor (IS), a wearable sensor, and a mobile application. Objective: To evaluate the clinical outcomes, medical decisions, and patient-reported outcomes associated with using this digital health offering in patients with uncontrolled hypertension in rural primary practices in the United Kingdom. Methods: Patients prescribed [greater than or equal to] 2 anti-hypertensives co-ingested the IS with prescribed BP medications whilst simultaneously wearing the wearable sensor for 2 weeks. Clinic BP was measured on days 1 and 14. Adherence and ADL patterns, were measured via the IS and wearable sensor. Subjects returned to the clinic at week 4 to discuss the next steps in therapy based on the data. Results: 151 patients met the inclusion/exclusion criteria, and 95% completed the 2 week trial. Out of those who completed the study, BP control (<140/ 90; <140/85 in diabetics) was achieved in 37% of patients after 2 weeks. The mean change in systolic blood pressure (SBP) was -9 [+ or -] 17 mm Hg, and the mean change in diastolic blood pressure (DBP) was -5 [+ or -] 9 mm Hg. The average number of steps-per-day was 6,137 [+ or -] 3,378. Interventions were tailored based on the data: 132 patients received medicines use reviews, 97 received adherence counseling, 17 had medication changes, and 2 were referred to a hypertension specialist (some patients received 2 or 3 of these interventions). Most patients (85%) had a good experience and thought the platform was easy to understand and convenient to use as measured by a satisfaction survey. Conclusions: In patients with uncontrolled blood pressure in everyday practice, the inclusion of a digital health service may help practitioners to identify the specific medication and lifestyle factors contributing to persistent hypertension, and to provide evidence-based advice and interventions for improved management. doi: 10.1038/jhh.2015.90