JMIR Publications

ABSTRACT

Background:

Uncontrolled hypertension leads to significant morbidity and mortality. The use of mHealth technology such as smartphones for remote blood pressure (BP) monitoring has improved BP control. Increase in BP control is more significant when patients can remotely communicate with their healthcare providers through technologies and receive feedback. Little is known about the predictors of remote blood pressure monitoring among hypertensive population.

Objective:

The objective of this study was to quantify the predictors of smartphone and tablet use in achieving health goals and communicating with healthcare providers via text messaging among hypertensive patients in the US.

Methods:

This study was a cross-sectional, secondary analysis of 2017 and 2018 Health Information National Trends Survey (HINTS) 5, Cycles 1 and 2 data. A total of 3,045 respondents answered “Yes” to the question “Has a doctor or other healthcare provider ever told you that you had high blood pressure or hypertension?” which defined the subpopulation used for this study. We applied the HINTS full sample weight to calculate population estimates and the 50 replicate weights to calculate the standard errors of the estimates. We used design-adjusted descriptive statistics to describe characteristics of the hypertensive respondents based on relevant survey items. Design-adjusted multivariable logistic regression models were fitted to estimate predictors of “achieving health goals with the help of smartphone or tablet” and “sending or receiving a text message to/from a healthcare provider in the last 12 months”.

Results:

An estimated 36.9%, SE:0.9% (183,285,150/497,278,883) of the weighted US adult population had hypertension. The mean age of the hypertensive population was 58.3 years (SE:0.48). Almost three-quarters of those with hypertension (74%) have accessed the internet; however, lower proportions have used smartphones or tablets to achieve health-related goals (36.1%) and text messaging to communicate with their healthcare professionals (30%). Electronic communication with the doctor or doctor’s office through email or internet (OR 2.93, 95%CI 1.85-4.63; P˂.001) and having a wellness App (OR 1.82, 95%CI 1.16-2.86; P=.02) were significant predictors of using text message communication with a healthcare professional, adjusting for other demographic and technology-related variables. The odds of achieving health-related goals with the help of a tablet or smartphone declined significantly with older age (P˂.001) and ownership of basic cellphones (P=.04). However, they increased significantly with being female (P=.045) or married (P=.03), having a wellness App (P˂.001), using other devices apart from smartphones or tablets to monitor health (P=.008), making health treatment decisions (P=.048), and discussing with a provider (P=.02) with the help of a tablet or smartphone.

Conclusions:

Intervention measures accounting for age, gender, marital status, and patient’s technology-related health behaviors are required to increase smartphones and tablets use in self-care and text message communication with healthcare providers.