Tele Health Applications in the Self-Management of Hypertensive Patients: A Review

Abstract

Developments in science and technology have been influential in the creation of new service approaches such as telehealth and telenursing. Telehealth applications are implemented to provide services such as remote health assessment, medical diagnosis, necessary intervention and guidance, and health counselling to people who cannot reach health services. Today, telehealth applications are seen among the approaches that contribute to the development of self-management skills and improving the quality of life, especially in individuals with chronic diseases. In chronic disease management; in addition to maintaining the treatment plan, it is important to increase the knowledge level of the patients with various training and support programs, to ensure compliance with the treatment and to gain self-management skills. Providing optimum blood pressure control in hypertensive patients is possible with effective disease management. Self-management support which is provided to hypertensive patients; it includes gaining knowledge, skills and confidence in disease management, providing resources to maintain self-care, supporting in the decision-making process, helping in diagnosing and coping with problems, and referral to community resources. Telehealth applications emerge as an alternative and innovative way of providing self-management support to hypertensive patients. The most preferred and widely used applications for hypertension management are mobile applications with monitoring facilities. With telehealth applications designed for hypertension self-management, patients can be followed up in terms of basic clinical information, training and counselling can be provided, and in this way, it is aimed to reduce hospital/emergency service admissions, support their adherence to treatment and reduce care costs. It is expected that the interest in telehealth and telenursing applications will gradually increase and become widespread with the increase in the number of patients requesting the service and the innovations in technology.

Keywords

• Hpertension
• Self-management
• tele- nursing
• tele-health

Hipertansif Hastaların Öz-Yönetiminde Tele Sağlık Uygulamaları: Geleneksel Derleme/ Tele Health Applications in the Self-Management of Hypertensive Patients: A Review

Abstract

Bilim ve teknoloji alanındaki gelişmeler, tele sağlık, tele hemşirelik gibi yeni hizmet yaklaşımlarının oluşturulmasında etkili olmuştur. Tele sağlık uygulamaları, sağlık hizmetine ulaşamayan kişilere uzaktan sağlık değerlendirmesi, tıbbi teşhisinin sağlanması, gerekli müdahale ve yönlendirmenin yapılması, sağlık danışmanlığı veril-mesi gibi hizmetlerin ulaştırılmasını sağlamak amacıyla uygulanmaktadır. Günümüzde, tele sağlık uygulamaları, özellikle kronik hastalığı olan bireylerde öz-yönetim becerilerinin geliştirilmesine ve yaşam kalitelerinin yükseltilmesine katkı sağlayan yaklaşımlar arasında görülmektedir. Kronik hastalık yönetiminde; tedavi pla-nının sürdürülmesinin yanı sıra çeşitli eğitim ve destek programları ile hastaların bilgi düzeyinin yükseltilmesi, tedaviye uyumun sağlanması ve öz-yönetim becerilerinin kazandırılması önemlidir. Hipertansif hastalarda optimum kan basıncı kontrolünü sağlamak etkili bir hastalık yönetimi ile mümkün olabilmektedir. Hipertansif hastalara sağlanacak öz-yönetim desteği; bireye hastalık yöneti-minde bilgi, beceri ve güven kazandırmayı, öz bakımı sürdürmek için kaynak sağlamayı, karar verme sürecinde desteklemeyi, problemleri tanılama ve baş etmede yardımcı olmayı, toplum kaynaklarına sevk etmeyi içermektedir. Tele sağlık uygulamaları, hipertansif hastalara öz-yönetim desteğini sağlamanın alternatif ve yenilikçi bir yolu olarak karşımıza çıkmaktadır. Hipertansiyon yönetimi için en çok tercih edilen ve en yaygın kullanılan uygulamalar, izleme olanaklarına sahip mobil uygulamalardır. Hipertansiyon öz-yönetimi için tasarlanmış tele sağlık uygulamaları ile hastaların temel klinik bilgiler yönünden takibi yapılabilmekte, eğitim ve danışmanlık verilebilmekte ve bu yolla hastane/acil servise başvurularının azaltılması, tedaviye uyumlarının desteklenmesi ve bakım maliyetlerinin düşürülmesi hedeflenmektedir. Hizmeti talep eden hasta sayılarındaki artış ve teknolojideki yeniliklerle birlikte tele sağlık ve tele hemşirelik uygulamalarına ilginin giderek artacağı ve yaygınlaşacağı beklenmektedir.

Keywords

• Hipertansiyon
• öz-yönetim
• tele hemşirelik
• tele sağlık

Supporting Institution

yok

Thanks

yok

References

1. 1. Türkiye Endokrinoloji ve Metabolizma Derneği. Hipertansiyon tanı ve tedavi kılavuzu. 2018. https://temd.org.tr/bilimsel-calisma-gruplari?redirect=obezite-dislipidemi-hipertansiyon pdf. Erişim Tarihi: 21 Şubat 2022.
2. 2. Stergiou GS, Palatini P, Parati G, O'Brien E, Januszewicz A, Lurbe E. et al. European society of hypertension council and the european society of hypertension working group on blood pressure monitoring and cardiovascular variability. 2021. European society of hypertension practice guidelines for office and out-of-office blood pressure measurement. J Hypertens. 2021;39(7):1293-1302. DOI: 10.1097/HJH.0000000000002843
3. 3. Petrie JR, Guzik TJ, Touyz RM, Diabetes, hypertension, and cardiovascular disease: clinical ınsights and vascular mechanisms, Canadian Journal of Cardiology. 2018;34(5):575-584. DOI: 10.1016/j.cjca.2017.12.005
4. 4. WHO. Hypertension, 2022. Erişim: https://www.who.int/news-room/fact-sheets/detail/hypertension Erişim tarihi: 07 Ağustos 2022.
5. 5. NCD Alliance, International Diabetes Federation and World Heart Federation. Call for simultaneous, Action on diabetes and hypertension for more resilient health systems, 2021. https://ncdalliance.org/resources/pressure-points-call-for-simultaneous-action-on-diabetes-and- hypertension-for-more-resilient-health-systems. Erişim Tarihi: 03 Ağustos 2022.
6. 6. Satman I, Omer B, Tutuncu Y, Kalaca S, Gedik S, Dinccag N, ve ark. TURDEP-II Study Group. Twelve-year trends in the prevalence and risk factors of diabetes and prediabetes in Turkish adults. Eur J Epidemiol. 2013 Feb;28(2):169-80. DOI: 10.1007/s10654-013-9771-5
7. 7. WHO, Home/ Publications/ Overview/ Hypertension Turkey 2020 country profile Hypertension Turkey 2020 country profile https://cdn.who.int/media/docs/default-source/country-profiles/hypertension/tur_en.pdf?sfvrsn=a5c754a2_9&download=true. Erişim tarihi:02.03.2022.
8. 8. İncirkuş K, Nahcivan NÖ. Kronik hastalık yönetimi için bir rehber: kronik bakım modeli. F.N. Hem Derg. 2015;23(1):66-75.

9. 9. Atan G, Karabulutlu EY. Esansiyel hipertansiyonu olan hastaların yaşam biçimi, yaşam kalitesi ve tedaviye uyumunun incelenmesi. Türkiye Klinikleri Hemşirelik Bilimleri Dergisi. 2016; 8(1): 17-25.
10. 10. Foroumandi E, Kheirouri S, Alizadeh M. The potency of education programs for management of blood pressure through increasing self-efficacy of hypertensive patients: A systematic review and meta-analysis. Patient Education and Counseling,2020;103(3).451-461..DOI: 1016/j.pec.2019.09.018
11. 11. Burnier M. Drug adherence in hypertension. Pharmacol Res.2017;125:142–9. DOI: 10.1016/j.phrs.2017.08.015.
12. 12. Roth GA, Abate D, Abate KH, Abay SM, Abbafati C, Abbasi N, et al. Global, regional, and national age-sex-specific mortality for 282 causes of death in 195 countries and territories, 1980–2017: a systematic analysis for the global burden of disease study 2017. The Lancet,2018; 392(10159):1736-1788. DOI: 10.1016/S0140-6736(18)32203-7
13. 13. Nielsen JØ, Shrestha AD, Neupane D, Kallestrup P. Non-adherence to anti-hypertensive medication in low- and middle-income countries: a systematic review and meta-analysis of 92443 subjects. J Hum Hypertens. 2017,31(1):14-21. DOI: 10.1038/jhh.2016.31.
14. 14. Yacob G. Tedla, Leonelo E. Bautista, Drug side effect symptoms and adherence to antihypertensive medication, American Journal of Hypertension.2016;29(6):772–779. DOI: 10.1093/ajh/hpv185
15. 15. Shalini, Goel MK. Non-adherence to anti-hypertensive treatment. Indian J Comm Health. 2020;32(1):126-129. DOI: 10.47203/IJCH.2020.v32i01.025
16. 16. Noone C, Leahy J, Morrissey EC, Newell J, Newell M, Dwyer CP, et al. Comparative efficacy of exercise and anti-hypertensive pharmacological interventions in reducing blood pressure in people with hypertension: A network meta-analysis. Eur J Prev Cardiol. 2020 Feb;27(3):247-255. DOI: 10.1177/2047487319879786
17. 17. Xu T, Yu X, Ou S, Liu X, Yuan J, Tan X, Chen Y. Adherence to antihypertensive medications and stroke risk: a dose‐response meta‐analysis. J Am Heart Assoc. 2017;6: e006371. DOI: 10.1161/JAHA.117.006371
18. 18. Warburton DER, Bredin SSD. Health benefits of physical activity: a systematic review of current systematic reviews. Curr Opin Cardiol. 2017 Sep;32(5):541-556. DOI: 10.1097/HCO.0000000000000437.
19. 19. Palafox B, McKee M, Balabanova D, AlHabib KF, Avezum AJ, Bahonar A, et al. Wealth and cardiovascular health: A cross-sectional study of wealth-related inequalities in the awareness, treatment and control of hypertension in high-, middle- and low-income countries. Int J Equity Health. 2016;15(1):199. DOI: 10.1186/s12939-016-0478-6.
20. 20. Long E, Ponder M, Bernard S. Knowledge, attitudes, and beliefs related to hypertension and hyperlipidemia self-management among African-American men living in the southeastern. United States. Patient Educ Couns. 2017: 100(5):1000-1006. DOI: 10.1016/j.pec.2016.12.011.
21. 21. Jones LM, Rosemberg MS, Wright KD. Opportunities for the advanced practice nurse to enhance hypertension knowledge and self-management among african american women. Clin Nurse Spec. 2017;31(6):311-318. DOI: 10.1097/NUR.0000000000000331.
22. 22. Aşılar RH. Hipertansiyonda tedaviye uyum ve öz-bakım yönetimi. Turk J Cardiovasc Nurs 2015;6(11):151-9. DOI: 10.5543/khd.2015.014.
23. 23. Bobrow K, Farmer AJ, Springer D, Shanyinde M, Yu LM, Brennan T, et al. Mobile phone text messages to support treatment adherence in adults with high blood pressure (SMS-Text Adherence Support [star]): A single-blind, randomized trial. Circulation. 2016 Feb 9;133(6):592-600. DOI: 10.1161/CIRCULATIONAHA.115.017530.
24. 24. Yatim HM, Wong YY, Lim SH, Hassali MA, Hong YH, Dali AF, Neoh CF. Evaluation of a group-based hypertension self-management education programme among hypertensive community dwellers. European Journal of Integrative Medicine. 2018;24:79-84. DOI: 10.1016/J.EUJIM.2018.10.016
25. 25. Huang B, Li Z, Wang Y, Xia J, Shi T, Jiang J, et al. Effectiveness of self-management support in maintenance haemodialysis patients with hypertension: A pilot cluster randomized controlled trial. Nephrology (Carlton). 2018;23(8):755-763. DOI: 10.1111/nep.13098.
26. 26. Mata ARL, Landeta ASU, Perez ALA, Dugarte MJL, Acevedo LAMA, Guillena MHJL. Factors associated with the level of knowledge about hypertension in primary care patients. Medicina Universitaria, 2017;19(77):184-8. DOI: 10.1016/j.rmu.2017.10.008
27. 27. Zinat Motlagh SF, Chaman R, Ghafari SR, Parisay Z, Golabi MR, Eslami AA, Babouei A. Knowledge, treatment, control, and risk factors for hypertension among adults in southern İran. Int J Hypertens. 2015:897070. DOI: 10.1155/2015/897070.
28. 28. Kilic M, Uzunçakmak T, Ede H. The effect of knowledge about hypertension on the control of high blood pressure. International Journal of the Cardiovascular Academy 2.2016; 27–32. DOI: 10.1016/j.ijcac.2016.01.003
29. 29. Rahmawati R, Bajorek B. Factors affecting self-reported medication adherence and hypertension knowledge: A cross-sectional study in rural villages, Yogyakarta Province, Indonesia. Chronic Illness. 2018;14(3):212-227. DOI:10.1177/1742395317739092
30. 30. Agyei-Baffour P, Tetteh G, Quansah DY, Boateng D. Prevalence and knowledge of hypertension among people living in rural communities in Ghana: A mixed method study. Afr Health Sci. 2018 Dec;18(4):931-941. DOI: 10.4314/ahs.v18i4.12
31. 31. Clark E.C. Nurse led interventions in hypertension, Published by Springer International Publishing AG, part of Springer Nature 2018, M. Burnier (ed.), Drug adherence in hypertension and cardiovascular protection, updates in hypertension and cardiovascular protection, Chapter 18. DOI: 10.1007/978-3-319-76593-8_18
32. 32. Himmelfarb CR, Commodore-Mensah Y, Hill MN. Expanding the role of nurses to ımprove hypertension care and control globally. Annals of Global Health. 2016 Mar-Apr;82(2):243-253. DOI: 10.1016/j.aogh.2016.02.003.
33. 33. Israfil I, Making M.A. The role of community nurses in the prevention of complications on hypertension patients in ıntegrated health centers. Jurnal Info Kesehatan.2019; 17(2), 108–118. DOI: 10.31965/infokes.Vol17.Iss2.320
34. 34. Balduino AFA, Mantovani MF, Lacerda MR, Marin MJS, Wall ML. Experience of hypertensive patients with self-management of health care. J AdvNurs 2016;72(11):2684-94. DOI: 10.1111/jan.13022
35. 35. Williams B, Mancia G, Spiering W, AgabitiRosei E, Azizi M, Burnier M, et al. ESC Scientific Document Group. 2018 ESC/ESH Guidelines for the management of arterial hypertension. Eur Heart J. 2018 Sep;39(33):3021-3104. DOI: 10.1093/eurheartj/ehy339.
36. 36. Park E, Kim J. The ımpact of a nurse-led home visitation program on hypertension self-management among older community-dwelling koreans. Public Health Nurs. 2016 Jan-Feb;33(1):42-52. DOI: 10.1111/phn.12220.
37. 37. Delavar F, Pashaeypoor S, Negarandeh R. The effects of self-management education tailored to health literacy on medication adherence and blood pressure control among elderly people with primary hypertension: A randomized controlled trial, Patient Education and Counseling.2020;103(2),336-342. DOI: 10.1016/j.pec.2019.08.028.
38. 38. Tezcan, C. Sağlığa Yenilikçi Bir Bakış Açısı: Mobil Sağlık, 2016. Yayın No: TÜSİAD-T/2016-03/575. file:///D:/indir/tusiad-mobil-saglik.pdf. Erişim tarihi: 02.03.2022.
39. 39. Ebrahimabadi M, Rafiei F, Nejat N. Can tele-nursing affect the supportive care needs of patients with cancer undergoing chemotherapy? A randomized controlled trial follow-up study. Support Care Cancer. 2021 Oct;29(10):5865-5872. DOI: 10.1007/s00520-021-06056-5.
40. 40. Komariah M, Maulana S, Platini H, Pahria T. A scoping review of telenursing's potential as a nursing care delivery model in lung cancer during the COVID-19 pandemic. J Multidiscip Healthc. 2021 Nov 2;14:3083-3092. DOI: 10.2147/JMDH.S337732.
41. 41. Carotenuto A, Traini E, Fasanaro AM, Battineni G, Amenta F. Tele-neuropsychological assessment of alzheimer's disease. J Pers Med. 2021 Jul 21;11(8):688. DOI: 10.3390/jpm11080688.
42. 42. Allen M, Aylott M, Loyola M, Morıc M, Saffarek L. Nurses: extending carethrough telehealth. Journal of Communication and Computer, 2015; 12(3). DOI: 10.17265/1548-7709/2015.03.003.
43. 43. Mohsen MM, Riad NA, Badawy AE, Gafar SE, El-Hammed BM, Eltomy EM. Tele-nursing versus routine outpatient teaching for ımproving arterial blood pressure and body mass ındex for hypertensive patients. American Journal of Nursing Research. 2020;8(1),18-26. DOI: 10.12691/ajnr-8-1-3.
44. 44. Mohammed MH, Hassan A. Tele-nursing: opportunities for nurses to shape their profession's future. International Journal of Novel Research in Healthcare and Nursing.2020; 7(3), 660-676.
45. 45. Ghoulami-Shilsari F, Esmaeilpour Bandboni M. Tele-nursing in chronic disease care: A systematic review. Jundishapur J Chronic Dis Care. 2019; 8(2): e84379. DOI: 10.5812/jjcdc.84379.
46. 46. Mileski M, Kruse CS, Catalani J, Haderer T. Adopting telemedicine for the self-management of hypertension: systematic review. JMIR Med Inform. 2017 Oct 24;5(4):e41. DOI: 10.2196/medinform.6603.
47. 47. Omboni S, Caserini M, Coronetti C. Telemedicine and m-health in hypertension management: technologies, applications and clinical evidence. High Blood Press Cardiovasc Prev. 2016 Sep;23(3):187-96. DOI: 10.1007/s40292-016-0143-6.
48. 48. Omboni S. Connected health in hypertension management. Front Cardiovasc Med. 2019 Jun 13;6:76. DOI: 10.3389/fcvm.2019.00076.
49. 49. Omboni S, Ferrari R. The role of telemedicine in hypertension management: focus on blood pressure telemonitoring. Curr Hypertens Rep. 2015 Apr;17(4):535. DOI: 10.1007/s11906-015-0535-3.
50. 50. Mohammadi R, Ayatolahi Tafti M, Hoveidamanesh S, Ghanavati R, Pournik O. Reflection on mobile applications for blood pressure management: a systematic review on potential effects and ınitiatives. Stud Health Technol Inform. 2018; 247:306-310. DOI: 10.3233/978-1-61499-852-5-306.
51. 51. Cavero-Redondo I, Saz-Lara A, Sequí-Dominguez I, Gómez-Guijarro MD, Ruiz-Grao MC, Martinez-Vizcaino V, Álvarez-Bueno C. Comparative effect of eHealth interventions on hypertension management-related outcomes: A network meta-analysis. Int J Nurs Stud. 2021;124:104085. DOI: 10.1016/j.ijnurstu.2021.104085.
52. 52. Zare S, Rezaee R, Aslani A, Shirdeli M, Kojuri J. Moving toward community based tele health services using m health for hypertensive patients. Int J Technol Assess Health Care. 2019;35(5):379-383. DOI: 10.1017/S0266462319000655.
53. 53. Keskin D, Polat Ü. The effect of nurse-led telephone support on adherence to blood pressure control and drug treatment in individuals with primary hypertension: A randomized controlled study. International Journal of Nursing Practice.2021. 2022 Jun;28(3):e12995. DOI: 10.1111/ijn.12995
54. 54. Oza A, Chapman K. Distance learning support of hypertension self-management. J Hypertens Manag. 2020; 6:52:1-8. DOI: 10.23937/2474-3690/1510052
55. 55. Sakinah S, Nurdin Sul. Tele nursing and self-management among patient with hypertension. Malahayati International Journal of Nursing and Health Science. 2020;3.103-109. DOI: 10.33024/minh.v3i2.3358.
56. 56. Li R, Liang N, Bu F, Hesketh T. The effectiveness of self-management of hypertension in adults using mobile health: systematic review and meta-analysis. JMIR Mhealth Uhealth. 2020 Mar ;27;8(3):e17776. DOI: 10.2196/17776.
57. 57. Song T, Liu F, Deng N, Qian S, Cui T, Guan Y, et al. A Comprehensive 6A framework for ımproving patient self-management of hypertension using mhealth services: qualitative thematic analysis. J Med Internet Res 2021; 23(6) :e 25522. DOI: 10.2196/25522
58. 58. Choi WS, Choi JH, Oh J, Shin IS, Yang JS. Effects of remote monitoring of blood pressure in management of urban hypertensive patients: a systematic review and meta-analysis. Telemed J E Health. 2020 Jun;26(6):744-759. DOI: 10.1089/tmj.2019.0028.
59. 59. Han H, Guo W, Lu Y, Wang M. Effect of mobile applications on blood pressure control and their development in China: a systematic review and meta-analysis, Public Health. 2020; 185:356–63. DOI: 10.1016/j.puhe.2020.05.024