Digital Health: The Future Model of Detection and the Benefits of Behaviour Change Conversations to Improve Hypertension via Telemedicine
Keywords:
digital health, hypertension, wearable electronic devices, behaviour modification, telemedicineAbstract
Hypertension is a leading cause of cardiovascular disease, with high morbidity and mortality in adults around the world. During the COVID-19 pandemic, Digital health is a new alternative technology for blood pressure measurement by digital devices, improving the management of hypertension. Several researches have shown the benefit of digital health and behavior modification. This paper reviews the digital health approach in combination with doctor consultations and patient education. The goal is the establishment of effective digital platforms for self-monitoring and tele-monitoring of blood pressure. Patient education should be encouraged, and clinicians need to be supported in the early detection and effective management of hypertension via virtual clinics. The digital health approach, combined with artificial intelligence and behavior modification, can help physicians in the screening, detection and management of hypertension, reducing the risk of serious complications. In addition, wearable technologies or health applications can be used to manage hypertension, empowering people to manage their own condition. This article describes the importance of the aetiology of hypertension and risk factors in the improvement of hypertension. Conversation skills, technologies and knowledge are required to successfully manage hypertension. Digital health can be a novel approach for health promotion in Thailand and is currently available in private hospitals; in the near future, it needs to become more popular across Thailand. However, further research in Thailand is needed to improve technologies and standardize digital health intervention.
References
Aekplakorn, W., Sangthong, R., Kessomboon, P., Putwatana, P., Inthawong, R., Taneepanichskul, S., Sritara, P., Sangwatanaroj, S., Chariyalertsak, S., & National Health Examination Survey IV study group (2012). Changes in prevalence, awareness, treatment and control of hypertension in Thai population, 2004-2009: Thai National Health Examination Survey III-IV. Journal of Hypertension, 30(9), 1734–1742. https://doi.org/10.1097/HJH.0b013e3283568158
Akuiyibo, S., Anyanti J., & Amoo, B. (2022). Effects of behaviour change communication on hypertension and diabetes related knowledge, attitude and practices in Imo and Kaduna States: A quasi-experimental study. BMC Public Health, 22, 715. https://doi.org/10.1186/s12889-022-13139-3
Albury, C., Hall, A., Syed, A., Ziebland, S., Stokoe, E., Roberts, N., Webb, H., & Aveyard, P. (2019). Communication practices for delivering health behaviour change conversations in primary care: A systematic review and thematic synthesis. BMC Family Practice, 20(1), 111. https://doi.org/10.1186/s12875-019-0992-x
Agbaje, A. O., Barker, A. R., & Tuomainen, T. P. (2022). Effects of arterial stiffness and carotid intima-media thickness progression on the risk of overweight/obesity and elevated blood pressure/hypertension: A cross-lagged cohort study. Hypertension (Dallas, Tex.: 1979), 79(1), 159–169. https://doi.org/10.1161/HYPERTENSIONAHA.121.18449
Agbaje, A. O., Barker, A. R., & Tuomainen, T. P. (2022). Effects of Arterial Stiffness and Carotid Intima-Media Thickness Progression on the Risk of Overweight/ Obesity and Elevated Blood Pressure/Hypertension: A Cross-Lagged Cohort Study. Hypertension (Dallas, Tex.: 1979), 79(1), 159–169. https://doi.org/10.1161/HYPERTENSIONAHA.121.18449
Australian Institute of Health & Welfare. (2022). Digital health. Retrieved from https://www.aihw.gov.au/reports/australias-health/digital-health
Botdorf, J., Chaudhary, K., & Whaley-Connell, A. (2011). Hypertension in Cardiovascular and Kidney Disease. Cardiorenal Medicine, 1(3), 183–192. https://doi.org/10.1159/000329927
Burnier, M., Kjeldsen, S. E., Narkiewicz, K., Egan, B., & Kreutz, R. (2022). Hypertension management during the COVID-19 pandemic: What can we learn for the future?. Blood Pressure, 31(1), 47–49. https://doi.org/10.1080/08037051.2022.2058909
Citoni, B., Figliuzzi, I., Presta, V., Volpe, M., & Tocci, G. (2022). Home blood pressure and telemedicine: a modern approach for managing hypertension during and after COVID-19 pandemic. High Blood Pressure & Cardiovascular Prevention: The Official Journal of The Italian Society of Hypertension, 29(1), 1–14. https://doi.org/10.1007/s40292-021-00492-4
da Silva, E. K. P., Barreto, S. M., Brant, L. C. C., Camelo, L. V., Araújo, E. M., Griep, R. H., Fonseca, M. J. M. D., Pereira, A. D. C., & Giatti, L. (2022). Gender, race/skin colour and incidence of hypertension in ELSA-Brasil: An intersectional approach. Ethnicity & health, 13(2), 198-208. https://doi.org/10.1080/13557858.2022.2108377
Durukan, B. N., Vardar Yagli, N., Calik Kutukcu, E., Sener, Y. Z., & Tokgozoglu, L. (2022). Health related behaviours and physical activity level of hypertensive individuals during COVID-19 pandemic. International journal of rehabilitation research. Internationale Zeitschrift fur Rehabilitationsforschung Revue internationale de recherches de readaptation, 45(2), 176–183. https://doi.org/10.1097/MRR.0000000000000519
Freeman, H. (1987). Health promotion talk in family practice encounters. Social Science & Medicine, 25(8), 961-966. https://doi.org/10.1016/0277-9536(87)90267-X.
Hanssen, H., Boardman, H., Deiseroth, A., Moholdt, A., Simonenko, M., Kränkel, N., & Niebauer, J. (2022). Personalized exercise prescription in the prevention and treatment of arterial hypertension: A Consensus Document from the European Association of Preventive Cardiology (EAPC) and the ESC Council on Hypertension. European Journal of Preventive Cardiology, 29(1), 205–215, https://doi.org/10.1093/eurjpc/zwaa141
Hare, A. J., Chokshi, N., & Adusumalli, S. (2021). Novel digital technologies for blood pressure monitoring and hypertension management. Current Cardiovascular Risk Reports, 15(8), 11. https://doi.org/10.1007/s12170-021-00672-w
Jagannathan, R., Patel, S. A., Ali, M. K., & Narayan, K. M. V. (2019). Global updates on cardiovascular disease mortality trends and attribution of traditional risk factors. Current Diabetes Reports, 19(7), 44-56. https://doi.org/10.1007/s11892-019-1161-2
Kario, K., Harada, N., & Okura, A. (2022). Digital therapeutics in hypertension: Evidence and perspectives. Journal of hypertension, 79(10), 2148-2158. https://doi/full/10.1161/HYPERTENSIONAHA.122.19414
Kitt, J., Fox, R., & Tucker, K. L. (2020). Digital health: New approaches in Hypertension Management. Journal of Cardiology and Cardiovascular Sciences, 4(1), 18-23. https://doi.org/10.29245/2578-3025/2020/1.1186
Kung, H. C., & Xiu, J. (2015). Hypertension-related mortality in the United States, 2000-2013. Retrieved from http://bit.ly/3Du4Krj
Labrique, A., Agarwal, S., & Tamrat, T. (2020). WHO digital health guidelines: A milestone for global health. NPJ Digital Medicine, 3(120), 165-178. https://doi.org/10.1038/s41746-020-00330-2
Li, E. C., Heran, B. S., & Wright, J. M. (2014). Angiotensin Converting Enzyme (ACE) inhibitors versus angiotensin receptor blockers for primary hypertension. The Cochrane Database of Systematic Reviews, 2014(8), CD009096. https://doi.org/10.1002/14651858.CD009096.pub2
McDonough, A., Matura, L., & Carroll, D. (2011). Symptom experience of Pulmonary Arterial Hypertension Patients. Clinical Nursing Research, 20(2), 120-134. https://doi.org/10.1177/1054773810391249
Miller, E. R., Ramsey, I. J., Tran, L. T., Tsourtos, G., Baratiny, G., Manocha, R., & Olver, I. N. (2016). How Australian general practitioners engage in discussions about alcohol with their patients: A cross-sectional study. BMJ open, 6(12), e013921. https://doi.org/10.1136/bmjopen-2016-013921
Nichols, W. W., & Edwards, D. G. (2001). Arterial elastance and wave reflection augmentation of systolic blood pressure: Deleterious effects and implications for therapy. Journal of Cardiovasc Pharmacol Therapeut, 6(1), 5-21. https://doi.org/10.1177/107424840100600102
NIHR Evidence National Health Research. (2022). What is digital health technology and what can it do for me?. Retrieved from https://evidence.nihr.ac.uk/collection/what-is-digital-health-technology/
Palacholla, R. S., Fischer, N., Coleman, A., Agboola, S., Kirley, K., Felsted, J., Katz, C., Lloyd, S., & Jethwani, K. (2019). Provider- and Patient-Related Barriers to and Facilitators of Digital Health Technology Adoption for Hypertension Management: Scoping Review. JMIR cardio, 3(1), e11951. https://doi.org/10.2196/11951
Persson, E., & floodmark, S. (2017). Nutritional habits and physical activity among university students in Thailand. Retrieved from https://www.diva-portal.org/smash/get/diva2:1105220/FULLTEXT01.pdf
Phonphet, C., Suwanno, J., Thiamwong, L., Mayurapak, C., & Ninla-Aesong, P. (2022). Translation and Cross-cultural Adaptation of the Self-care of Hypertension Inventory for Thais with Hypertension.The Journal of Cardiovascular Nursing, 10, PMID: 35090153. https://doi.org/10.1097/JCN.0000000000000895
Photi, J., Chavasit, V., Chitchang, U., Egkantrong, P., Chinchanupap, K., & Boonpraderm, A. (2020). Reduction of Sodium Intake from Papaya Salad with the Use of Sodium-Reduced Fermented Fish in Producing Traditional Seasoning Sauce. Journal of Nutritional Science and Vitaminology, 66(Suppl), S173–S178. https://doi.org/10.3177/jnsv.66.S173.
Rai, S. K., Fung, T. T., Lu, N., Keller, S. F., Curhan, G. C., & Choi, H. K. (2017). The Dietary Approaches to Stop Hypertension (DASH) diet, Western diet, and risk of gout in men: prospective cohort study. BMJ (Clinical Research Ed.), 357, j1794. https://doi.org/10.1136/bmj.j1794
Riet, L. R., Esch , J. V., Roks, A., Meirecker, A. H., & Jan Danver, A. H. (2015). Hypertension Renin–Angiotensin–Aldosterone System Alterations. Circulation Research, 116(6), 960-975. https://doi.org/10.1161/CIRCRESAHA.116.30358.
Rosendorff, C., Black, H. R., Cannon, C. P., Gersh, B. J., Gore, J., Izzo, J. L., Jr, Kaplan, N. M., O’Connor, C. M., O’Gara, P. T., Oparil, S., American Heart Association Council for High Blood Pressure Research, American Heart Association Council on Clinical Cardiology, & American Heart Association Council on Epidemiology and Prevention. (2007). Treatment of hypertension in the prevention and management of ischemic heart disease: A scientific statement from the American Heart Association Council for High Blood Pressure Research and the Councils on Clinical Cardiology and Epidemiology and Prevention. Circulation, 115(21), 2761–2788. https://doi.org/10.1161/CIRCULATIONAHA.107.183885
Rusmevichientong, P., Morales, C., Castorena, G., Sapbamrer, R., Seesen, M., & Siviroj, P. (2021). Dietary salt-related determinants of hypertension in Rural Northern Thailand. International Journal of Environmental Research and Public Health, 18(2), 377-398. https://doi.org/10.3390/ijerph18020377
Sapsirisopa, K., & Sapsirisopa, S. (2017). The renal complication screening development of patients with high blood pressure, Muang Nongkhai District, Nongkhai Province. EAU Heritage Journal Science and Technology, 11(2), 207–214. (in Thai)
Singh, P., Dubey, R., Singh, L., Singh, N., Kumar, C., Kashyap, S., & Subramanian, S. (2022). Mixed effect of alcohol, smoking, and smokeless tobacco use on hypertension among adult population in India: A nationally representative cross-sectional study. International Journal of Environmental Research and Public Health, 19(6), 3239. https://doi.org/10.3390/ijerph19063239
Sparrenberger, F., Cichelero, F. T., Ascoli, A. M., Fonseca, F. P., Weiss, G., Berwanger, O., Fuchs, S. C., Moreira, L. B., & Fuchs, F. D. (2009). Does psychosocial stress cause hypertension? A systematic review of observational studies. Journal of Human Hypertension, 23(1), 12–19. https://doi.org/10.1038/jhh.2008.74
Sun, J., Wang, X., Terry, P. D., Ren, X., Hui, Z., Lei, S., Wang, C., & Wang, M. (2022). Interaction effect between overweight/obesity and alcohol consumption on hypertension risk in China: A longitudinal study. BMJ Open, 12(7), e061261. https://doi.org/10.1136/bmjopen-2022-061261
Tan, F., Oka, P., & Dambha, H. (2021). The association between self-efficacy and self-care in essential hypertension: A systematic review. BMC Family Practice, 22(44). https://doi.org/10.1186/s12875-021-01391-2
Thaworn, A., & Samruayruen, K. (2022). The effectiveness of health literacy program on self-care behavior among hypertensive patients, Tambon Aranyik Health Promotion Hospital, Mueang District, Phitsanulok Province. EAU Heritage Journal Science and Technology, 16(1), 65–77. (in Thai)
Theerapuncharoen, N., & Theerapuncharoen, W. (2016). Health risk for ASEAN people. EAU Heritage Journal Science and Technology, 10(2), 50–60. (in Thai)
Tucker, K. L., Sheppard, J. P., Stevens, R., Bosworth, H. B., Bove, A., Bray, E. P., Earle, K., George, J., Godwin, M., Green, B. B., Hebert, P., Hobbs, F. D. R., Kantola, I., Kerry, S. M., Leiva, A., Magid, D. J., Mant, J., Margolis, K. L., McKinstry, B., McLaughlin, M. A., & McManus, R. J. (2017). Self-monitoring of blood pressure in hypertension: A systematic review and individual patient data meta-analysis. PLoS Medicine, 14(9), e1002389. https://doi.org/10.1371/journal.pmed.1002389
Wang, Q., Su, M., Zhang, M., & Li, R. (2021). Integrating digital technologies and public health to fight Covid-19 Pandemic: Key technologies, applications, challenges and outlook of digital healthcare. International Journal of Environmental Research and Public Health, 18(11), 578-588. http://dx.doi.org/10.3390/ijerph18116053
Williams, B., Mancia, G., Spiering, W., Agabiti Rosei, E., Azizi, M., Burnier, M., Clement, D. L., Coca, A., de Simone, G., Dominiczak, A., Kahan, T., Mahfoud, F., Redon, J., Ruilope, L., Zanchetti, A., Kerins, M., Kjeldsen, S. E., Kreutz, R., Laurent, S., Lip, G. Y. H., & Authors/Task Force Members. (2018). 2018 ESC/ESH Guidelines for the management of arterial hypertension: The task force for the management of arterial hypertension of the European Society of Cardiology and the European Society of Hypertension: The task force for the management of arterial hypertension of the European Society of Cardiology and the European Society of Hypertension. Journal of hypertension, 36(10), 1953–2041. https://doi.org/10.1097/HJH.0000000000001940
World Health Organisation. (2020). Digital health. Retrieved from https://www.who.int/health-topics/digital-health#tab=tab_1
