Advancing Digital Health Interventions as a Clinically Applied Science for Blood Pressure Reduction: A Systematic Review and Meta-analysis

Stogios, Nicolette; Kaur, Bhagwanpreet; Huszti, Ella; Vasanthan, Jessica; Nolan, Robert P.

doi:10.1016/j.cjca.2019.11.010

Cited by 31 publications

(14 citation statements)

References 56 publications

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“…This randomized waitlist-controlled trial examined the effects of a self-efficacy theory-based Health IT intervention on the control of blood pressure, selfmanagement behavior, and QOL in patients with CAD. Its effectiveness for control of SBP is consistent with findings of a previous study (Stogios et al, 2020). Moreover, participants' self-management behavior and QOL were improved significantly.…”

Section: Discussionsupporting

confidence: 89%

“…Telebased nurse education aimed at reminding, encouraging, and motivating patients might be useful in this regard, but there have been few robust scientific evaluations of these interventions. In a systematic review of 17 randomized controlled trials of 5,780 patients with cardiovascular disease, an organized theoretical framework of behavior change via Internet-or mobile-based digital interventions showed a significant treatment effect of SBP control (Stogios, Kaur, Huszti, Vasanthan, & Nolan, 2020). Application of teleweb-based Health IT interventions is a low-cost and widely available alternative for self-management in patients with CAD at highest risk for cardiovascular events.…”

mentioning

confidence: 99%

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Effectiveness of Theory‐Based Health Information Technology Interventions on Coronary Artery Disease Self‐Management Behavior: A Clinical Randomized Waitlist‐Controlled Trial

Hong

Chen

Chang

et al. 2021

J of Nursing Scholarship

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Purpose Secondary prevention of coronary artery disease, self‐management behavior, and blood pressure control are important to cardiovascular event prevention and promotion of quality of life (QOL), but they are underutilized. The purpose of this study was to investigate the effects of a self‐efficacy theory–based health information technology intervention implemented through blood control and patient self‐management. Design A clinical randomized waitlist‐controlled trial. Methods The study was conducted at a medical center in Taipei, Taiwan. A total of 60 subjects were randomly assigned to either the immediate intervention (experimental) group or the waitlist control group. The primary endpoint was systolic blood pressure at 3 months; secondary end points included self‐management behavior and QOL. Treatment for the immediate intervention group lasted 3 months, while the waitlist control group received routine care for the first 3 months, at which point they crossed over to the intervention arm and received the same intervention as the experimental group for another 3 months. Both groups were evaluated by questionnaires and physiological measurements at both 3 and 6 months postadmission. The results were analyzed using generalized estimating equations. Results Systolic blood pressure significantly improved for the intervention group participants at 3 months, when there was also significant improvement in self‐management behavior and QOL. There was no significant or appreciable effect of time spent in the waitlist condition, with treatments in the two conditions being similarly effective. Conclusion The use of a theory‐based health information technology treatment compared with usual care resulted in a significant improvement in systolic blood pressure, self‐management behavior, and QOL in patients with coronary artery disease. Clinical Relevance This treatment would be a useful strategy for clinical care of cardiovascular disease patients, improving their disease self‐management. It also may help guide further digital health care strategies during the COVID‐19 pandemic.

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Section: Discussionsupporting

confidence: 89%

mentioning

confidence: 99%

Effectiveness of Theory‐Based Health Information Technology Interventions on Coronary Artery Disease Self‐Management Behavior: A Clinical Randomized Waitlist‐Controlled Trial

Hong

Chen

Chang

et al. 2021

J of Nursing Scholarship

View full text Add to dashboard Cite

show abstract

“…Digital interventions also significantly improved the clinical indicators related to adherence to treatment among patients with cardiovascular disease [ 58 , 68 , 72 ]. For example, eHealth interventions significantly improved adherence to treatment [ 84 ] and blood pressure control [ 29 , 37 , 41 , 42 , 45 , 85 ]. Recent systematic reviews of mHealth interventions for hypertension [ 28 ] and coronary artery disease [ 30 ] have provided evidence that mHealth interventions are effective for blood pressure control, self-management, and medication adherence.…”

Section: Discussionmentioning

confidence: 99%

Effectiveness of Digital Counseling Environments on Anxiety, Depression, and Adherence to Treatment Among Patients Who Are Chronically Ill: Systematic Review

Paalimäki-Paakki¹,

Virtanen²,

Henner³

et al. 2022

J Med Internet Res

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Background Patients who are chronically ill need novel patient counseling methods to support their self-care at different stages of the disease. At present, knowledge of how effective digital counseling is at managing patients’ anxiety, depression, and adherence to treatment seems to be fragmented, and the development of digital counseling will require a more comprehensive view of this subset of interventions. Objective This study aims to identify and synthesize the best available evidence on the effectiveness of digital counseling environments at improving anxiety, depression, and adherence to treatment among patients who are chronically ill. Methods Systematic searches of the EBSCO (CINAHL), PubMed, Scopus, and Web of Science databases were conducted in May 2019 and complemented in October 2020. The review considered studies that included adult patients aged ≥18 years with chronic diseases; interventions evaluating digital (mobile, web-based, and ubiquitous) counseling interventions; and anxiety, depression, and adherence to treatment, including clinical indicators related to adherence to treatment, as outcomes. Methodological quality was assessed using the standardized Joanna Briggs Institute critical appraisal tool for randomized controlled trials or quasi-experimental studies. As a meta-analysis could not be conducted because of considerable heterogeneity in the reported outcomes, narrative synthesis was used to synthesize the results. Results Of the 2056 records screened, 20 (0.97%) randomized controlled trials, 4 (0.19%) pilot randomized controlled trials, and 2 (0.09%) quasi-experimental studies were included. Among the 26 included studies, 10 (38%) digital, web-based interventions yielded significantly positive effects on anxiety, depression, adherence to treatment, and the clinical indicators related to adherence to treatment, and another 18 (69%) studies reported positive, albeit statistically nonsignificant, changes among patients who were chronically ill. The results indicate that an effective digital counseling environment comprises high-quality educational materials that are enriched with multimedia elements and activities that engage the participant in self-care. Because of the methodological heterogeneity of the included studies, it is impossible to determine which type of digital intervention is the most effective for managing anxiety, depression, and adherence to treatment. Conclusions This study provides compelling evidence that digital, web-based counseling environments for patients who are chronically ill are more effective than, or at least comparable to, standard counseling methods; this suggests that digital environments could complement standard counseling.

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“…Reconhecendo a emergência do uso de aplicativos eletrônicos como uma ferramenta auxiliar ao cuidado em saúde 40 , pode-se sugerir que futuros estudos nacionais testem a introdução de aplicativos, com conteúdos educativos e/ou aconselhamento digital sob o prisma da APS. Cabe mencionar os resultados promissores de intervenções que se utilizam de aconselhamento digital para a redução da pressão arterial sistólica 41 .…”

Section: Discussionunclassified

Intervenções educativas para atividade física em adultos brasileiros: revisão sistemática

et al. 2021

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OBJETIVO: Sumarizar as principais evidências de intervenções educativas delineadas para o aumento dos níveis de atividade física (AF) em adultos brasileiros. MÉTODOS: Revisão sistemática de estudos de intervenção conduzidos no Brasil, que implementaram componentes educativos com a finalidade de promover o aumento dos níveis de AF em populações de adultos (18 a 65 anos). Em outubro de 2020, buscas sistemáticas foram conduzidas em seis bases de dados e nas listas de referências dos artigos avaliados. RESULTADOS: Dos 2.511 artigos iniciais, nove compuseram a síntese. Foram observadas amostras com características específicas (como vulnerabilidade social, inatividade física e sobrepeso ou obesidade), com maior número de mulheres. Cinco intervenções (55,6%) ocorreram nos cenários da atenção primária à saúde (APS) do Sistema Único de Saúde (SUS). Apenas em quatro estudos (44,4%) houve descrição dos referenciais pedagógicos estruturantes das abordagens educativas, dentro os quais o aconselhamento se configurou como a estratégia mais utilizada, como aquelas realizadas por meio de encontros presenciais, visitas domiciliares, palestras e chamadas telefônicas (n = 8; 88,9%). Resultados positivos foram observados em três distintos indicadores: aumento do volume semanal de AF (n = 4); aumento do índice de AF no lazer (n = 1); e aumento da proporção de mulheres classificadas como “muito ativas/ativas” (n = 1). Visto as especificidades amostrais, o domínio “seleção dos participantes” apresentou elevado número de intervenções com alto risco de viés. CONCLUSÕES: As abordagens educativas produziram alguns efeitos positivos em distintos indicadores de AF, destacando-se o aconselhamento como principal estratégia utilizada e as abordagens que envolveram outras temáticas de saúde, como nutrição e estresse. Contudo, frente aos diversos determinantes da AF no Brasil, é importante que futuras intervenções sejam conduzidas em variadas localizações do país, de forma que avaliem, de maneira mais ampla, seus processos de implementação e articulação com os distintos profissionais que atuam na APS.

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Advancing Digital Health Interventions as a Clinically Applied Science for Blood Pressure Reduction: A Systematic Review and Meta-analysis

Cited by 31 publications

References 56 publications

Effectiveness of Theory‐Based Health Information Technology Interventions on Coronary Artery Disease Self‐Management Behavior: A Clinical Randomized Waitlist‐Controlled Trial

Effectiveness of Theory‐Based Health Information Technology Interventions on Coronary Artery Disease Self‐Management Behavior: A Clinical Randomized Waitlist‐Controlled Trial

Effectiveness of Digital Counseling Environments on Anxiety, Depression, and Adherence to Treatment Among Patients Who Are Chronically Ill: Systematic Review

Intervenções educativas para atividade física em adultos brasileiros: revisão sistemática

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