Opportunities to Leverage Telehealth Approaches Along the Hypertension Control Cascade in Sub-Saharan Africa

Muiruri, Charles; Manavalan, Preeti; Jazowski, Shelley A.; Knettel, Brandon A.; Vilme, Helene; Zullig, Leah L.

doi:10.1007/s11906-019-0983-2

Cited by 11 publications

(14 citation statements)

References 44 publications

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“…Out of the fourteen unique studies included in this review, the majority (n = 11) demonstrated a significant improvement in either systolic or diastolic blood pressure, and two studies showed a non-significant improvement in either systolic blood pressure, diastolic blood pressure, or percentage of participants who achieved target blood pressure levels. Indeed, the broader literature on mobile health applications for NCD management in LMICs has generally shown promise for improving clinical outcomes, and our results contribute to the existing literature through demonstrating an overall positive impact of telemedicine for hypertension management [10][11][12]33]. Eight of the nine studies that investigated interventions to improve patient medical management displayed significant reductions in blood pressure, whereas only three of the five studies that assessed interventions to modify behavioral risk factors reported significant changes.…”

Section: Discussionmentioning

confidence: 50%

“…Telemedicine has the potential to reduce barriers to primary healthcare in LMICs, including transportation burden, overcrowded facilities, and healthcare workforce shortages [9]. While several studies have investigated the scope of telehealth and mobile services for NCD management in LMICs, many of these reviews assessed technology platforms for oneway communication such as unidirectional text messaging or automated patient reminders [10][11][12]. To our knowledge, there are few studies specifically evaluating telemedicine applications involving direct communication between healthcare providers or between providers and patients.…”

Section: Introductionmentioning

confidence: 99%

“…Through telemedicine, remote and vulnerable patient populations may obtain instant access to tailored care through remote providers. Literature reviews addressing telemedicine interventions for blood pressure management in LMICs are limited [ 11 , 14 ].…”

Section: Introductionmentioning

confidence: 99%

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Telemedicine interventions for hypertension management in low- and middle-income countries: A scoping review

et al. 2021

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Hypertension remains the leading cause of cardiovascular disease worldwide and disproportionately impacts patients living in low- and middle-income countries (LMICs). Telemedicine offers a potential solution for improving access to health care for vulnerable patients in LMICs. Objectives The purpose of this scoping review was to summarize the evidence for telemedicine interventions for blood pressure management in LMICs and assess the relationships between the telemedicine intervention characteristics and clinical outcomes. Design Published studies were identified from the following databases (from their inception to May 2020): PubMed, Scopus, and Embase. Search terms related to “Low and Middle Income Countries,” “Telemedicine,” and “Hypertension” were used, and clinical outcomes were extracted from the screened articles. Results Our search resulted in 530 unique articles, and 14 studies were included in this review. Five studies assessed telemedicine interventions for patient-provider behavioral counseling, four assessed patient-provider medical management, and five assessed provider-provider consultation technologies. Out of fourteen individual studies, eleven demonstrated a significant improvement in systolic or diastolic blood pressure in the intervention group. Of the eight studies that reported difference-in-differences changes in systolic blood pressure, between-arm differences ranged from 13.2 mmHg to 0.4 mmHg. Conclusions The majority of the studies in this review demonstrated a significant reduction in blood pressure with use of the telemedicine intervention, though the magnitude of benefit was not consistently large. Limitations of the studies included small sample sizes, short duration, and intervention heterogeneity. Current evidence suggests that telemedicine may provide a promising approach to increase access to care and improve outcomes for hypertension in LMICs, especially during events that limit access to in-person care, such as the COVID-19 pandemic. However, high-quality clinical trials of sufficient size and duration are needed to establish the impact and role of telemedicine in hypertension care. The protocol for this review was not registered.

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Section: Discussionmentioning

confidence: 50%

Section: Introductionmentioning

confidence: 99%

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Telemedicine interventions for hypertension management in low- and middle-income countries: A scoping review

et al. 2021

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“…In this study, the proportion of caregivers who reported using a mobile phone (85%) was similar to the national mobile phone subscription rate in Tanzania (82%) [ 13 ]. In sub-Saharan Africa, data plans are often inexpensive, and their use is widespread regardless of socioeconomic status [ 22 , 23 ]. Furthermore, investments in mobile phone infrastructure have led to an estimated 93.7% cell tower coverage nationwide, suggesting that an intervention delivered by mobile phone has a high potential reach in Tanzania [ 24 ].…”

Section: Discussionmentioning

confidence: 99%

Caregiver Acceptability of Mobile Phone Use for Pediatric Cancer Care in Tanzania: Cross-sectional Questionnaire Study

Schroeder¹,

Maiarana²,

Gisiri³

et al. 2021

JMIR Pediatr Parent

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Background There is a 60% survival gap between children diagnosed with cancer in low- and middle-income countries (LMICs) and those in high-income countries. Low caregiver knowledge about childhood cancer and its treatment results in presentation delays and subsequent treatment abandonment in LMICs. However, in-person education to improve caregiver knowledge can be challenging due to health worker shortages and inadequate training. Due to the rapid expansion of mobile phone use worldwide, mobile health (mHealth) technologies offer an alternative to delivering in-person education. Objective The aim of this study is to assess patterns of mobile phone ownership and use among Tanzanian caregivers of children diagnosed with cancer as well as their acceptability of an mHealth intervention for cancer education, patient communication, and care coordination. Methods In July 2017, caregivers of children <18 years diagnosed with cancer and receiving treatment at Bugando Medical Centre (BMC) were surveyed to determine mobile phone ownership, use patterns, technology literacy, and acceptability of mobile phone use for cancer education, patient communication, and care coordination. Descriptive statistics were generated from the survey data by using mean and SD values for continuous variables and percentages for binary or categorical variables. Results All eligible caregivers consented to participate and completed the survey. Of the 40 caregivers who enrolled in the study, most used a mobile phone (n=34, 85%) and expressed high acceptability in using these devices to communicate with a health care provider regarding treatment support (n=39, 98%), receiving laboratory results (n=37, 93%), receiving reminders for upcoming appointments (n=38, 95%), and receiving educational information on cancer (n=35, 88%). Although only 9% (3/34) of mobile phone owners owned phones with smartphone capabilities, about 74% (25/34) self-reported they could view and read SMS text messages. Conclusions To our knowledge, this is the first study to assess patterns of mobile phone ownership and use among caregivers of children with cancer in Tanzania. The high rate of mobile phone ownership and caregiver acceptability for a mobile phone–based education and communication strategy suggests that a mobile phone–based intervention, particularly one that utilizes SMS technology, could be feasible in this setting.

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“…Remote interventions enable access to medical services by people who have onerous conditions that limit their ability to go to face-to-face appointments, for reasons of disease limitation (PB5), age or living in locations distant from medical centers. In addition, digital health through smartphones, increasingly widespread among the low-income public, is an alternative for meeting the needs of low-income people, who do not always have access to health information and quality medical care (Muiruri et al, 2019). Still referring to the low-income population, remote interventions would avoid having to take time off work for in-person consultations, an option not always feasible for this public (Kelso & Feagins, 2018).…”

Section: Personal Subsystemmentioning

confidence: 99%

Analysis of barriers and benefits associated with e-health technology applications

Calegari

Fettermann

2022

Journal of Technology Management & Innovation

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People's interest in health issues has stimulated the development of healthcare-oriented technology products. For the process of developing and using e-health technologies, it is necessary to know the challenges and facilitators for their implementation and wide acceptance. this research aims to identify, among the e-health technologies that are already available in the literature, what are the barriers for implementation/adoption of these technologies, as well as the main benefits arising from their use. In order to identify research opportunities on the subject of e-health, the method of systematic literature review was performed using the Preferred Reporting Items for Systematic Reviews and Meta-Analysis (PRISMA) methodological approach. 130 records are considered for the review. The results obtained about barriers and benefits were structured from the sociotechnical (social -people/society; technical -machines/technology) systems approach. As a result, we expect to identify perspectives for the direction of new products development and opportunities for future research.

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Opportunities to Leverage Telehealth Approaches Along the Hypertension Control Cascade in Sub-Saharan Africa

Cited by 11 publications

References 44 publications

Telemedicine interventions for hypertension management in low- and middle-income countries: A scoping review

Telemedicine interventions for hypertension management in low- and middle-income countries: A scoping review

Caregiver Acceptability of Mobile Phone Use for Pediatric Cancer Care in Tanzania: Cross-sectional Questionnaire Study

Analysis of barriers and benefits associated with e-health technology applications

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