Smartphone technology using wireless monitoring tools are now widely available to help individuals monitor their blood pressure, but little is known under which conditions such technology can effect positive behavior changes or clinical outcomes. To study the influence of wireless self-monitoring program and patient activation measures on health behaviors, medication adherence, and blood pressure levels as well as control of blood pressure in hypertensive patients.
Design and Method:
We examined a subset of 95 hypertensive participants from a 6-month randomized controlled trial designed to determine the utility of wireless self-monitoring program (n = 52 monitoring program, n = 43 control) which consisted of blood pressure monitoring device connected with iPhone, reminder for self-monitoring, online disease management program as well as mobile application for monitoring and education, compared with control group receiving standard disease management program. Study participants provided measures of patient activation, health behaviors including smoking, drinking and exercise, medication adherence, and blood pressure levels. We assessed the influence of wireless self-monitoring as a moderator of the relationship between patient activation and health behaviors, medication adherence as well as control of blood pressure.
Improvements in patient activation were associated with improvements in cigarette smoking (β = −0.46, P < .001) and blood pressure control (β = 0.04, P = .02). This relationship was further strengthened in reducing cigarettes (β = −0.60, P < .001), alcohol drinking (β = −0.26, P = .01) as well as systolic (β = −0.27, P = .02) and diastolic blood pressure (β = −0.34, P = .007) at 6 months among individuals participating in the wireless self-monitoring program. No differences were observed with respect to medication adherence.
Participation in a wireless self-monitoring program provides individuals motivated to improve their health management an added benefit above and beyond that of motivation alone. Hypertensive individuals eager to change health behaviors are excellent candidates mHealth self-monitoring.
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