Your browser doesn't support javascript.
Patient Interaction Phenotypes With an Automated Remote Hypertension Monitoring Program and Their Association With Blood Pressure Control: Observational Study.
Davoudi, Anahita; Lee, Natalie S; Chivers, Corey; Delaney, Timothy; Asch, Elizabeth L; Reitz, Catherine; Mehta, Shivan J; Chaiyachati, Krisda H; Mowery, Danielle L.
  • Davoudi A; Department of Biostatistics, Epidemiology & Informatics, University of Pennsylvania, Philadelphia, PA, United States.
  • Lee NS; National Clinician Scholars Program, University of Pennsylvania, Philadelphia, PA, United States.
  • Chivers C; Leonard Davis Institute of Health Economics, University of Pennsylvania, Philadelphia, PA, United States.
  • Delaney T; Corporal Michael J Crescenz Veterans Affairs Medical Center, Philadelphia, PA, United States.
  • Asch EL; Penn Medicine Predictive Healthcare, University of Pennsylvania Health System, Philadelphia, PA, United States.
  • Reitz C; Center for Healthcare Innovation, University of Pennsylvania, Philadelphia, PA, United States.
  • Mehta SJ; Leonard Davis Institute of Health Economics, University of Pennsylvania, Philadelphia, PA, United States.
  • Chaiyachati KH; Center for Healthcare Innovation, University of Pennsylvania, Philadelphia, PA, United States.
  • Mowery DL; Department of Medicine, Perelman School of Medicine, University of Pennsylvania, Philadelphia, PA, United States.
J Med Internet Res ; 22(12): e22493, 2020 12 03.
Article in English | MEDLINE | ID: covidwho-1186721
Semantic information from SemMedBD (by NLM)
1. CD69 protei PART_OF C0027627
Subject
CD69 protei
Predicate
PART_OF
Object
C0027627
2. CD69 protei AFFECTS C0005823
Subject
CD69 protei
Predicate
AFFECTS
Object
C0005823
3. Hypertensive disease PROCESS_OF Adult
Subject
Hypertensive disease
Predicate
PROCESS_OF
Object
Adult
4. CD69 protein, human|CD69 PART_OF Neoplasm Metastasis
Subject
CD69 protein, human|CD69
Predicate
PART_OF
Object
Neoplasm Metastasis
5. CD69 protein, human|CD69 AFFECTS Blood Pressure
Subject
CD69 protein, human|CD69
Predicate
AFFECTS
Object
Blood Pressure
6. Hypertensive disease PROCESS_OF Adult
Subject
Hypertensive disease
Predicate
PROCESS_OF
Object
Adult
ABSTRACT

BACKGROUND:

Automated texting platforms have emerged as a tool to facilitate communication between patients and health care providers with variable effects on achieving target blood pressure (BP). Understanding differences in the way patients interact with these communication platforms can inform their use and design for hypertension management.

OBJECTIVE:

Our primary aim was to explore the unique phenotypes of patient interactions with an automated text messaging platform for BP monitoring. Our secondary aim was to estimate associations between interaction phenotypes and BP control.

METHODS:

This study was a secondary analysis of data from a randomized controlled trial for adults with poorly controlled hypertension. A total of 201 patients with established primary care were assigned to the automated texting platform; messages exchanged throughout the 4-month program were analyzed. We used the k-means clustering algorithm to characterize two different interaction phenotypes program conformity and engagement style. First, we identified unique clusters signifying differences in program conformity based on the frequency over time of error alerts, which were generated to patients when they deviated from the requested text message format (eg, ###/## for BP). Second, we explored overall engagement styles, defined by error alerts and responsiveness to text prompts, unprompted messages, and word count averages. Finally, we applied the chi-square test to identify associations between each interaction phenotype and achieving the target BP.

RESULTS:

We observed 3 categories of program conformity based on their frequency of error alerts those who immediately and consistently submitted texts without system errors (perfect users, 51/201), those who did so after an initial learning period (adaptive users, 66/201), and those who consistently submitted messages generating errors to the platform (nonadaptive users, 38/201). Next, we observed 3 categories of engagement style the enthusiast, who tended to submit unprompted messages with high word counts (17/155); the student, who inconsistently engaged (35/155); and the minimalist, who engaged only when prompted (103/155). Of all 6 phenotypes, we observed a statistically significant association between patients demonstrating the minimalist communication style (high adherence, few unprompted messages, limited information sharing) and achieving target BP (P<.001).

CONCLUSIONS:

We identified unique interaction phenotypes among patients engaging with an automated text message platform for remote BP monitoring. Only the minimalist communication style was associated with achieving target BP. Identifying and understanding interaction phenotypes may be useful for tailoring future automated texting interactions and designing future interventions to achieve better BP control.
Subject(s)
Keywords

Full text: Available Collection: International databases Database: MEDLINE Document Type: Article Main subject: Blood Pressure / Text Messaging / Hypertension / Monitoring, Physiologic Subject: Blood Pressure / Text Messaging / Hypertension / Monitoring, Physiologic Type of study: Controlled clinical trial / Prognostic study / Risk factors Language: English Journal: J Med Internet Res Clinical aspect: Therapy Year: 2020

Similar

MEDLINE

...
LILACS

LIS


Full text: Available Collection: International databases Database: MEDLINE Document Type: Article Main subject: Blood Pressure / Text Messaging / Hypertension / Monitoring, Physiologic Subject: Blood Pressure / Text Messaging / Hypertension / Monitoring, Physiologic Type of study: Controlled clinical trial / Prognostic study / Risk factors Language: English Journal: J Med Internet Res Clinical aspect: Therapy Year: 2020
...