Mobile health strategies for blood pressure self-management in urban populations with digital barriers: systematic review and meta-analyses.
Mobile health strategies for blood pressure self-management in urban populations with digital barriers: systematic review and meta-analyses.
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DOI：
10.1038/s41746-021-00486-5
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发表时间：
2021-07-22
影响因子：
15.2
通讯作者：
Sarkar U
中科院分区：
文献类型：
--
作者：
Khoong EC;Olazo K;Rivadeneira NA;Thatipelli S;Barr-Walker J;Fontil V;Lyles CR;Sarkar U
移动医疗（mHealth）技术可改善高血压预后，但尚不清楚这种益处是否适用于所有人群。本综述旨在描述移动健康干预对数字健康使用差异人群血压结果的影响。我们进行了系统搜索，以确定高收入国家城市环境中收缩压（SBP）结果的研究，这些研究包括数字健康差异人群，定义为平均年龄≥65岁；受教育程度较低（≥60%≤高中）；和/或种族/少数民族（美国研究中非西班牙裔白人<50%）。使用已建立的自我管理分类法对干预措施进行分类。我们进行了叙事合成；在六个月收缩压结果的随机临床试验（rct）中，我们进行了随机效应荟萃分析。纳入29篇文献（代表25项研究），其中15篇为随机对照试验。15项研究使用短信；12个使用过的移动应用程序。研究纳入了基于种族/民族（14）、教育（10）和/或年龄(6)的研究。常见的干预措施包括：生活方式建议（20）；提供自我监测设备（17）；以及数字设备使用方面的培训（15）。在7项随机对照试验的荟萃分析中，干预组6个月时收缩压降低（平均收缩压差= - 4.10,95% CI:[- 6.38, - 1.83]）具有显著性，但干预组与对照组之间收缩压变化无显著性差异（p = 0.48）。移动医疗工具的使用已经显示出慢性病管理的前景，但很少有研究包括老年人、受教育程度有限或少数民族人群。需要对这些人群进行进一步的强有力的研究，以确定哪种干预措施对不同的高血压患者最有效。
Mobile health (mHealth) technologies improve hypertension outcomes, but it is unknown if this benefit applies to all populations. This review aimed to describe the impact of mHealth interventions on blood pressure outcomes in populations with disparities in digital health use. We conducted a systematic search to identify studies with systolic blood pressure (SBP) outcomes located in urban settings in high-income countries that included a digital health disparity population, defined as mean age ≥65 years; lower educational attainment (≥60% ≤high school education); and/or racial/ethnic minority (<50% non-Hispanic White for US studies). Interventions were categorized using an established self-management taxonomy. We conducted a narrative synthesis; among randomized clinical trials (RCTs) with a six-month SBP outcome, we conducted random-effects meta-analyses. Twenty-nine articles (representing 25 studies) were included, of which 15 were RCTs. Fifteen studies used text messaging; twelve used mobile applications. Studies were included based on race/ethnicity (14), education (10), and/or age (6). Common intervention components were: lifestyle advice (20); provision of self-monitoring equipment (17); and training on digital device use (15). In the meta-analyses of seven RCTs, SBP reduction at 6-months in the intervention group (mean SBP difference = −4.10, 95% CI: [−6.38, −1.83]) was significant, but there was no significant difference in SBP change between the intervention and control groups (p = 0.48). The use of mHealth tools has shown promise for chronic disease management but few studies have included older, limited educational attainment, or minority populations. Additional robust studies with these populations are needed to determine what interventions work best for diverse hypertensive patients.
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DOI：
10.1016/j.ijmedinf.2019.02.004
发表时间：
2019-05-01
影响因子：
4.9
作者：
Gonzalez-Sanchez, Jesus;Recio-Rodriguez, Jose, I;Iturregui-San Nicolas, Eguskine
通讯作者：
Iturregui-San Nicolas, Eguskine
影响因子：
4.9
作者：
Gordon, Nancy P;Crouch, Elizabeth
通讯作者：
Crouch, Elizabeth
影响因子：
2.7
作者：
Derose, Kathryn P.;Williams, Malcolm V.;Wong, Eunice C.
通讯作者：
Wong, Eunice C.
影响因子：
--
作者：
Harris, Kathy;Jacobs, Gloria;Reeder, Julie
通讯作者：
Reeder, Julie
影响因子：
3.6
作者：
Fukuoka, Yoshimi;Vittinghoff, Eric;Hooper, Julie
通讯作者：
Hooper, Julie