Patient participation in treatment of hypertension using mobiles - MIHM
Short description
The main aim the project Mobile phone in Hypertension Management (MIHM) was to analyze whether self-reporting of symptoms and signs of illness via mobile phone increases adherence to treatment of high blood pressure and contributes to increased patient participation in the treatment. The sub-goals were:
• Analyze patients' and caregivers' (doctors, nurses and pharmacists) expectations of and experiences with blood pressure-lowering treatment.
• Identify factors that can contribute to improved communication between patients and healthcare providers.
• Develop an interactive web-based self-reporting system via mobile phone to support patients' experiences and experiences of high blood pressure, that is, how patients feel and experience their high blood pressure and their treatment.
• To evaluate this system in clinical practice.
Short Description of main results
•The developed system (PROMs) was reliable and easy to use
• After 8 weeks of using the system, the systolic blood pressure decreased -7 mmHg, diastolic - 4.9 mmHg
• Increased understanding of the relationship between blood pressure and lifestyle
• Increased awareness of the importance of following one's treatment
• Patients more active in follow-up appointments
• Visualization of patients' self-reports and the possibility to communicate these with doctors/nurses is a resource for person-centred care
• The strongest relationship was between medication intake and SBP
• Well-being and stress were associated with SBP and DBP
• Physical activity was associated only with SBP
• The study is unique in examining associations between self-measured blood pressure and self-reported medication intake, well-being, stress, physical activity and symptoms on the same day, over 56 consecutive days.
Larger and randomized studies including patients with more diverse adherence levels are needed to confirm our findings.
Click here to read about the continuation of the project, entitled Perhit: PERson-centredness in hypertension management using information technology.
Published scientific articles and other output
Mäkitalo, Å. (2019). eHälsa och självrapportering – ett pedagogiskt perspektiv. I G. Erlingsdottir & H. Sandberg (Red). eHälsa som samhällsfenomen– teori och perspektiv Lund: Studentlitteratur.
Mäkitalo, Å. Kjellgren, K. Säljö, R. (2018). Renderings of an invisible condition: Graphs as objects and means of communication in hypertension consultations. Symposia contribution to “The epistemic use of material objects in workplace participatory practices: Exploring the context of health” arranged at the EARLI SIG14, Learning and Professional Development conference on September 12-14 in Geneva.
Taft C, Hallberg I, Bengtsson U, Manhem K, Kjellgren K. Links between blood pressure and medication intake, well-being, stress, physical activity and symptoms reported via a mobile phone-based self-management support system: a cohort study in primary care. BMJ Open. 2018 Aug 23;8(8):e020849. doi: 10.1136/bmjopen-2017-020849.
Ulrika Bengtsson, Karin Kjellgren, Inger Hallberg, Karin Manhem, Charles Taft. Links between blood pressure and life-style factors reported via a mobile phone-based self-management support system. 28th European meeting on hypertension and cardiovascular protection, Barcelona, 8-11 June 2018.
Hallberg I, Ranerup A, Bengtsson U, Kjellgren K. Experiences, expectations and challenges of an interactive mobile phone-based system to support self-management of hypertension: patients' and professionals' perspectives. Patient Prefer Adherence. 2018 Mar 28;12:467-476.
Bengtsson U, Kjellgren K, Hallberg I, Lundin M, Mäkitalo Å. Patient contributions during primary care consultations for hypertension after self-reporting via a mobile phone self-management support system, Scand J Prim Health Care. 2018 Mar;36(1):70-79.
Bengtsson U, Kjellgren K. Hypertension self-management; Mobile-phone self-reports improve patient participation in clinical consultations. 27th European meeting on hypertension and cardiovascular protection, Milan, 16-19 June 2017.
Lundin, M. & Mäkitalo, Å. (2017). Co-designing technologies in the context of hypertension care: negotiating participation and technology use in design meetings. Informatics for Health
and Social Care. 42(1), 18-31.
Mäkitalo, Å. (2017). Documentary Practices Revised: How patient-generated data transform consultations in hypertension care. Keynote at the conference Knowledge translation and self-management in chronic diseases: contexts, tools and practices, University of Lausanne, Switzerland, May 18-19, 2017.
Hallberg, I, Kjellgren, K, Ranerup, A. Användning av mobiltelefon vid behandling av högt blodtryck, Best Practice, 2016:25-27. http://www.epaper.dk/bpsediahjertekar/diabeteshjertekarse/diabetes-hjerte-19-se-juni-2016/
Bengtsson U, Kjellgren K, Hallberg I, Lindwall M, Taft C. Improved Blood Pressure Control Using an Interactive Mobile Phone Support System. J Clin Hypertens 2016, 18(2):101-108.
Commentary:
Gema Ruiz-Hurtado, Luis M. Ruilope. New Strategy to Control Blood Pressure: Interactive Mobile Phone Support J Clin Hypertens 14 oct 2015 | DOI: 10.1111/jch.12683
Hallberg I, Ranerup A, Kjellgren K. Supporting the self-management of hypertension: Patients’ experiences of using a mobile phone-based system. J Hum Hypertension. 2016, 30(2):141-146.
Thesis: Ulrika Bengtsson “Self-management in hypertension care” The Sahlgrenska Academy, University of Gothenburg 2015. Supervisors: Karin Kjellgren, Åsa Mäkitalo, Charles Taft. Awarded with price for best thesis at the Institute of Health and Care Science, Sahlgrenska Academy, 2015.
Hallberg I, Taft C, Ranerup A, Bengtsson U, Hoffmann M, Höfer S, Kasperowski D, Mäkitalo Å, Lundin M, Ring L, Rosenqvist U, Kjellgren K. Phases in development of an interactive mobile phone-based system to support self-management of hypertension. Integrated Blood Pressure Control. 2014:7; 19-28.
Bengtsson U, Kasperowski D, Ring L, Kjellgren K. Developing an interactive mobile phone self-report system. Part 1: Patient and professional perspectives, Blood Press. Oct2014, Vol. 23 Issue 5, p288-295. 8p. DOI: 10.3109/08037051.2014.883203.
Bengtsson U, Kjellgren K, Ring L, Höfer S, Taft C. Developing an interactive mobile phone self-report system. Part 2: Content validity and usability. Blood Press. Oct2014, Vol. 23 Issue 5, p296-306. 11p. DOI: 10.3109/08037051.2014.901009.
Bengtsson U, Kjellgren K, Hallberg I, Lindwall M, Taft C. (2014) Effects from using a hypertension specific mobile phone based self-management support system. 28th Conference of the European Health Psychology Society, 26-30th August 2014, Innsbruck, Austria.
Bengtsson, U, Kjellgren, K, Hallberg, I, Lindwall, M, Taft, C. (2014) Blood pressure decrease with a mobile phone-based system to support self-management. Journal of hypertension vol 32, e-supplement 1, Joint Meeting ESH – ISH Hypertension 13-16th June 2014, Athen, Greece.
Mäkitalo, Å. & Lundin, M. (2014). Changing relations? Participation, interaction and accountability in hypertension care. Paper presented at the International conference ICIP14 Interactional Competences in Institutional Practices, University of Neuchatel November 21-22, Switzerland.
Ranerup A, Hallberg I. Actors and intentions in the development process of a mobile phone platform for self-management of hypertension. Informatics for Health and Social Care. 2014 Jun 24:1-20.
Ranerup A, Hallberg I, Bengtsson U, Kjellgren K. (2012). Mastery and Autonomy in Medication with a Mobile Self-report System: A Project in Action, Conference proceeding Persuasive. Linköping 2012. Linköping June 6-8.
Bengtsson, U; Ring, L; Kjellgren, K. I. et al. (2013). Development of a mobile phone self-report system for persons with hypertension: focus group interviews with patients and providers, HPH 21 st International Conference on Health Promoting Hospitals and Health Services.
Bengtsson, U; Ring, L. ; Hallberg, I. et al. (2013). Development of a mobile phone self-report system for persons with hypertension: focus group interviews with patients and providers, Kardiovaskulära Vårmötet 2013.
Hallberg, I; Bengtsson, U; Kjellgren, K. I. (2012). Patientmedverkan i behandling av högt blodtryck med hjälp av mobiltelefon, Medicinska riksstämman.
Bengtsson, U; Kjellgren, K. I; Hallberg, I. (2012). Aspects of hypertension - a multi-perspective approach on the way towards adherence and self-management, Fifth Geneva conference on person-centered medicine.
Kjellgren, K. I; Taft, C. (2012). Optimizing adherence to hypertension treatment through a mobile phone-based self-report system, 5th Geneva Conference on Person-centered Medicine.
Mäkitalo, Å. & Nilsen, M. (2012) Co-production in the context of person-centred care. On professional transformation in current health care reform. Symposia paper to SIG 14 EARLI meeting 22-24 August 2012 in Antwerp, Belgium.
Nilsen, M. & Mäkitalo, Å. (2012) Co-producing knowing and knowers: Participatory research and the transformation of ‘the professional’ and ‘the patient’ in current health care reform. ProPEL conference in Stirling on“Professions and Professional Learning in Troubling Times: Emerging Practices and Transgressive Knowledges” 9-11 May 2012.
2011-2012 Postdoc: Digitala teknologier i medicinsk kommunikation: uppföljningsmöte om högt blodtryck som empiriskt fall. Funded by Swedish Research Council for Health, Working Life and Welfare (previously FAS, now FORTE). SEK 1,680 000.
Researchers
Karin Kjellgren, Professor Emerita, Linköping University.
Agneta Ranerup, Professor, University of Gothenburg.
Ulrika Bengtsson, Lecturer, Institute of health and care sciences, University of Gothenburg
Mikael Hoffman, PhD, Linköping University.
Dick Kasperowski, Department of philosophy, linguistics and theory of science, University of Gothenburg.
Åsa Mäkitalo, Department of education, communication and learning, University of Gothenburg
Charles Taft, Institute of health and care sciences, University of Gothenburg
Mona Lundin, Department of education, communication and learning, University of Gothenburg.
Lena Ring, Centre for Research Ethics & Bioethics, Uppsala University.
Stefan Höfer, Innsbruck Medical University, Department of Medical Psychology, Innsbruck, Austria.
Inger Hallberg, Institute of health and care sciences, University of Gothenburg, Department of Medical and Health Sciences (IMH), Linköping University, Linköping.