Health and Medical News and Resources

General interest items edited by Janice Flahiff

Letting patients change their own meds using apps and connected devices

Letting patients change their own meds using apps and connected devices.

Aneroid sphygmomanometer with stethoscope, use...

Aneroid sphygmomanometer with stethoscope, used for auscultatory blood pressure measurement. (Photo credit: Wikipedia)

From the 18 September 2014 post at iMedicalapps

A recent trial published in the Journal of the American Medical Association has demonstrated the efficacy of self-titration of blood pressure medications by patients with hypertension.

Personally, I’m a proponent of giving patients self-titration schedules, particularly in my patients with systolic heart failure in whom I’m trying to maximize medical therapy. It’s a strategy I use somewhat sparingly though in part because of the difficulty to follow the home monitoring these patients are doing between clinic visits.

In this study, the self-titration plan was agreed upon in a clinic visit and then transcribed onto a paper given to the patient. The patient then used an unconnected blood pressure cuff at home with pre-set parameters for the patient to notify their primary care physician if their readings were too high or too low. Notifications of self-titration were accomplished by having the patient send in paper notifications to their primary care physician.

There are clearly a number of opportunities here to streamline the process to help make it less cumbersome for the patient and improve the monitoring of patients undertaking this kind of self-titration strategy. There are a number of wireless blood pressure cuffs on the market as well as wired devices that can transmit data through USB connections to a computer.

With the coming standardization of health data being captured by personal health devices thanks to Google Fit and Apple HealthKit, this data can then be readily transferred into the electronic health record. Practice Fusion already does that with some personal health devices; Apple and Epic are working on developing that integration as well. Trials and pilots underway at institutions like Stanford and Duke are exploring the creation of automated alert systems to help filter the data being collected with pre-specified rules as it flows into their EHR.

There are a number of limitations in this study.

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November 3, 2014 - Posted by | Medical and Health Research News, Uncategorized | , , , ,

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