Characteristics and requirements of hypertensive patients willing to use digital health tools in the Chinese community: a multicentre cross-sectional survey

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Abstract

Background

Digital health tools (WeChat or mobile health apps) provide opportunities for new methods of hypertension management for hypertensive patients. However, the willingness of these patients to use social media and mobile health apps for hypertension management remains unclear. This study explored the characteristics and requirements of patients willing to use digital health (WDH) tools to manage hypertension.

Methods

From February to March 2018, we administered questionnaires to 1089 patients with hypertension at eight Chinese primary medical units. We assessed independent risk factors of WDH and requirement among WDH patients.

Results

Overall, 43% (465/1089) of participants were WDH patients, who were younger (58 ± 12 vs 61 ± 13 years) and had a greater proportion of employed individuals (31% vs 14%) and higher education levels (65% vs 52%) than the non-WDH patients (all P < 0.0001). After adjusting for other risk factors, higher education (OR: 0.52; 95% CI: 0.34–0.79), good medicine adherence (OR: 1.5; 95% CI: 1.0–2.3) and blood pressure self-monitoring (OR: 1.6; 95% CI: 1.2–2.3) remained significantly associated with WDH (all P < 0.05). WDH patients responded that digital health tools should try to provide a platform for blood pressure monitoring (42%), medication reminders (41%), hypertension knowledge (39%) and doctor-patient communication (32%).

Conclusion

Our survey suggested that among hypertensive patients, willingness to use digital health tools was significantly associated with education, medicine adherence and blood pressure self-monitoring. Digital health tool developers and researchers should pay particular attention to recruiting older, less educated and unemployed patients with less willingness and who are less technologically savvy and research the requirements of WDH patients (blood pressure monitoring, medication reminders, and knowledge education) in the future.

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mHealth 2.0: Experiences, Possibilities, and Perspectives

Stefan Becker, Talya Miron-Shatz, Nikolaus Schumacher … (2014)

With more than 1 billion users having access to mobile broadband Internet and a rapidly growing mobile app market, all stakeholders involved have high hopes that this technology may improve health care. Expectations range from overcoming structural barriers to access in low-income countries to more effective, interactive treatment of chronic conditions. Before medical health practice supported by mobile devices ("mHealth") can scale up, a number of challenges need to be adequately addressed. From a psychological perspective, high attrition rates, digital divide of society, and intellectual capabilities of the users are key issues when implementing such technologies. Furthermore, apps addressing behavior change often lack a comprehensive concept, which is essential for an ongoing impact. From a clinical point of view, there is insufficient evidence to allow scaling up of mHealth interventions. In addition, new concepts are required to assess the efficacy and efficiency of interventions. Regarding technology interoperability, open standards and low-energy wireless protocols appear to be vital for successful implementation. There is an ongoing discussion in how far health care-related apps require a conformity assessment and how to best communicate quality standards to consumers. "Apps Peer-Review" and standard reporting via an "App synopsis" appear to be promising approaches to increase transparency for end users. With respect to development, more emphasis must be placed on context analysis to identify what generic functions of mobile information technology best meet the needs of stakeholders involved. Hence, interdisciplinary alliances and collaborative strategies are vital to achieve sustainable growth for "mHealth 2.0," the next generation mobile technology to support patient care.

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Association of a Smartphone Application With Medication Adherence and Blood Pressure Control

Zhigang Lu, Niteesh K. Choudhry, Jessie L Juusola … (2018)

Medication nonadherence accounts for up to half of uncontrolled hypertension. Smartphone applications (apps) that aim to improve adherence are widely available but have not been rigorously evaluated.

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Best (but oft-forgotten) practices: the multiple problems of multiplicity-whether and how to correct for many statistical tests.

David L Streiner (2015)

Testing many null hypotheses in a single study results in an increased probability of detecting a significant finding just by chance (the problem of multiplicity). Debates have raged over many years with regard to whether to correct for multiplicity and, if so, how it should be done. This article first discusses how multiple tests lead to an inflation of the α level, then explores the following different contexts in which multiplicity arises: testing for baseline differences in various types of studies, having >1 outcome variable, conducting statistical tests that produce >1 P value, taking multiple "peeks" at the data, and unplanned, post hoc analyses (i.e., "data dredging," "fishing expeditions," or "P-hacking"). It then discusses some of the methods that have been proposed for correcting for multiplicity, including single-step procedures (e.g., Bonferroni); multistep procedures, such as those of Holm, Hochberg, and Šidák; false discovery rate control; and resampling approaches. Note that these various approaches describe different aspects and are not necessarily mutually exclusive. For example, resampling methods could be used to control the false discovery rate or the family-wise error rate (as defined later in this article). However, the use of one of these approaches presupposes that we should correct for multiplicity, which is not universally accepted, and the article presents the arguments for and against such "correction." The final section brings together these threads and presents suggestions with regard to when it makes sense to apply the corrections and how to do so.

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Author and article information

Contributors

Yong Liu:

ORCID: http://orcid.org/0000-0003-2224-4885

liuyong2099@126.com

Journal

Journal ID (nlm-ta): BMC Public Health

Journal ID (iso-abbrev): BMC Public Health

Title: BMC Public Health

Publisher: BioMed Central (London )

ISSN (Electronic): 1471-2458

Publication date (Electronic): 1 September 2020

Publication date PMC-release: 1 September 2020

Publication date Collection: 2020

Volume: 20

Electronic Location Identifier: 1333

Affiliations

[1 ]Department of Cardiology, Guangdong Provincial Key Laboratory of Coronary Heart Disease Prevention, Guangdong Cardiovascular Institute, Guangdong Provincial People’s Hospital, Guangdong Academy of Medical Sciences, Guangzhou, 510000 Guangdong China

[2 ]GRID grid.411847.f, ISNI 0000 0004 1804 4300, Guangdong Pharmaceutical University, ; Guangzhou, 510006 Guangdong China

[3 ]GRID grid.440180.9, ISNI 0000 0004 7480 2233, Department of Cardiology, , Dongguan People’s Hospital, ; Dongguan, 523000 Guangdong China

[4 ]Maoming People’s Hospital, Maoming, 525000 Guangdong China

[5 ]Department of Cardiology, First People’s Hospital of Kashgar, Kashgar, 844099 Xinjiang China

[6 ]Department of Cardiology, Longyan First Affiliated Hospital of Fujian Medical University, Longyan, 364000 Fujian China

Author information

Yong Liu http://orcid.org/0000-0003-2224-4885

Article

Publisher ID: 9462

DOI: 10.1186/s12889-020-09462-2

PMC ID: 7465797

PubMed ID: 32873273

SO-VID: a75b5872-e0fe-4d76-8a01-40cd07247dc9

License:

Open AccessThis article is licensed under a Creative Commons Attribution 4.0 International License, which permits use, sharing, adaptation, distribution and reproduction in any medium or format, as long as you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons licence, and indicate if changes were made. The images or other third party material in this article are included in the article's Creative Commons licence, unless indicated otherwise in a credit line to the material. If material is not included in the article's Creative Commons licence and your intended use is not permitted by statutory regulation or exceeds the permitted use, you will need to obtain permission directly from the copyright holder. To view a copy of this licence, visit http://creativecommons.org/licenses/by/4.0/. The Creative Commons Public Domain Dedication waiver ( http://creativecommons.org/publicdomain/zero/1.0/) applies to the data made available in this article, unless otherwise stated in a credit line to the data.

History

Date received : 25 February 2020

Date accepted : 27 August 2020

Funding

Funded by: Chinese Cardiovascular Association-China young and middle-aged clinical research fund-VG fund

Award ID: 2017-CCA-VG-020

Award Recipient : Yong Liu

Funded by: Cardiacare Sponsored Optimizing Antithrombotic Research Fund

Award ID: BJUHFCSOARF201801-10

Award Recipient : Yong Liu

Funded by: The Progress in Science and Technology Project of Guangzhou

Award ID: 201904010470

Award Recipient : Yong Liu

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ScienceOpen disciplines: Public health

Keywords: digital health tools,hypertension,willingness,community,blood pressure management

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ScienceOpen disciplines: Public health

Keywords: digital health tools, hypertension, willingness, community, blood pressure management

Characteristics and requirements of hypertensive patients willing to use digital health tools in the Chinese community: a multicentre cross-sectional survey

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PLOS Global Public Health

Most cited references 15

mHealth 2.0: Experiences, Possibilities, and Perspectives

Association of a Smartphone Application With Medication Adherence and Blood Pressure Control

Best (but oft-forgotten) practices: the multiple problems of multiplicity-whether and how to correct for many statistical tests.

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