Patientmedverkan i behandling av högt blodtryck via mobiltelefon - MIHM
Kort beskrivning
Huvudsyftet med projektet Mobile phone in Hypertension Management (MIHM) var att analysera om egenrapportering av symtom och sjukdomstecken via mobiltelefon ökar följsamhet till behandling av högt blodtryck och medverkar till ökad delaktighet från patienten i behandlingen. Projektet hade följande delmål:
• Analysera patienters och vårdgivares (läkares, sjuksköterskors och apotekares) förväntningar på och erfarenheter av blodtryckssänkande behandling.
• Identifiera faktorer som kan medverka till förbättrad kommunikationen mellan patienter och vårdgivare.
• Utveckla ett interaktivt webb baserat självrapporteringssystem via mobiltelefon för att stödja patienters upplevelser och erfarenheter av högt blodtryck, det vill säga hur patienter känner och erfar sitt höga blodtryck och sin behandling.
• Att utvärdera detta system i klinisk praxis
Kort beskrivning av huvudsakliga resultat
- Det utvecklade systemet (PROMs) var reliabelt och lätt att använda
- Efter 8 veckors användning av systemet sjönk systolisk blodtryck -7 mmHg, diastoliskt - 4.9 mmHg
- Ökad förståelse för samband mellan blodtryck och livsstil
- Ökad medvetenhet om betydelsen av att följa sin behandling
- Patienterna mer aktiva i uppföljningssamtal
- Visualisering av patienternas självrapporteringar och möjlighet att kommunicera dessa med läkare/sjuksköterska är en resurs för personcentrerad vård
- Starkast samband fanns mellan medicinintag och SBP
- Välbefinnande och stress var associerade med SBP och DBP
- Fysisk aktivitet var associerat endast med SBP
- Studien är unik när det gäller att undersöka samband mellan självmätt blodtryck och självrapporterat läkemedelsintag, välbefinnande, stress, fysisk aktivitet och symtom samma dag, under 56 dagar i följd.
Större och randomiserade studier inklusive patienter med mer olika följsamhetsnivåer behövs för att bekräfta våra fynd.
Publicerade vetenskapliga artiklar och annan medial 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.
Phd 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.
Forskare
Karin Kjellgren, professor emerita, Linköpings Universitet.
Agneta Ranerup, professor, Göteborgs Universitet.
Ulrika Bengtsson, Universitetslektor, Göteborgs Universitet.
Mikael Hoffman, PhD, Linköpings Universitet.
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.